Joint line plate fixation for tibial plateau fractures caused by hyperextension varus

Abstract

The present study evaluated the outcomes of internal fixation with a joint line plate in the treatment of tibial plateau fractures caused by hyperextension of the varus. The study included 25 cases (13 males and 12 females; age, 19-71 years) of tibial plateau fracture caused by hyperextension of the varus, which were treated at Puai Hospital, Tongji Medical College (Wuhan, China) between January 2015 and June 2017. Fractures were treated with internal fixations of the inner cortex with a self-clipped joint line plate made of steel. After the surgery, patients were examined immediately and at 3, 6 and 12 months. Healing was evaluated by X-ray examination. All cases were cured during follow-up. After surgery, one patient developed partial necrosis of the skin margin of the incision and recovered after a dressing change. Furthermore, one patient with a concomitant peroneal nerve injury and hypoesthesia recovered after treatment with neurotrophic drugs. No screw loosening, fractures or failure of the internal fixations occurred. According to the X-ray results, there were significant differences in the tibial plateau angle (TPA) and medial posterior slope angle (m-PSA) between the pre-operative stage and 12 months post-operatively (P<0.05). However, no significant differences in either the TPA or m-PSA were present between the immediate post-operative stage and 12 months post-operatively (P>0.05). In conclusion, internal fixation with a joint line plate is an appropriate treatment for tibial plateau fractures involving the anteromedial margin with good clinical efficacy.

Manejo de fractura de platillo tibial medial utilizando placas rim anteromedial y posteromedial

“…En lo que se refiere al uso de placas rim anteromediales, recientemente Huang et al 12 evaluaron 25 casos en los que utilizaron este tipo de placas en fracturas producidas por varo e hiperextensión, con buenos resultados clínicos y radiológicos al año de evolución, pero con mucha variabilidad en cuanto a implantes utilizados.…”

“…El uso de placas horizontales, también conocidas como placas rim, ha sido descrito en los últimos años como una alternativa sumamente útil para el enfrentamiento de estas fracturas. [6][7][8][9][10][11][12][13] A la fecha, existen varios reportes de fijación de las columnas lateral y posterior con placas rim. [6][7][8][9][10][11][12][13] Sin embargo, su uso en la región anteromedial sigue siendo de conocimiento limitado, 12 sin existir, a nuestro entender, reportes en la literatura de su uso en la región posteromedial.…”

“…[6][7][8][9][10][11][12][13] A la fecha, existen varios reportes de fijación de las columnas lateral y posterior con placas rim. [6][7][8][9][10][11][12][13] Sin embargo, su uso en la región anteromedial sigue siendo de conocimiento limitado, 12 sin existir, a nuestro entender, reportes en la literatura de su uso en la región posteromedial.…”

Clinical application of posterior tibial artery or peroneal artery perforator flap in curing plate exposure after ankle fracture fixation

“…In severe instances, these issues may escalate to secondary osteomyelitis, gravely affecting the patient's recovery trajectory. 12,13 The unique anatomical structure of the ankle, featuring relatively poor vascular supply compared to other joints, exacerbates the risk of complications. 14,15 These risks become especially pronounced if the fracture is accompanied by skin abrasions or open wounds, which may lead to bacterial biofilm formation, chronic infections and non-healing wounds.…”

“…Postoperative complications, including infections and steel plate exposure, can occur. In severe instances, these issues may escalate to secondary osteomyelitis, gravely affecting the patient's recovery trajectory 12,13 …”