Ligament Injuries Associated With Tibial Plateau Fractures

Delamarter, Rick B.; Hohl, Mason; Hopp, Emery

doi:10.1097/00003086-199001000-00031

Cited by 141 publications

(71 citation statements)

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“…The tibiofemoral circular fixation provides adequate bracing for any form of management of ligament disruption. Analysis of our patients confirmed that isolated injuries of the medial collateral ligament have a better prognosis than all other isolated or combined knee ligament injuries associated with fractures of the tibial plateau (Delamarter et al 1990).…”

Section: Discussionsupporting

confidence: 57%

“…Whether it is due to ligamentous laxity or bone deformity is debatable (Delamarter, Hohl and Hopp 1990). There is no general agreement as to whether the repair of associated ligament injuries at the time of the fixation of the fracture is necessary, but many believe that operative repair should be undertaken (Shelton, Neer and Grantham 1971;Wilppula and Bakalim 1972;Delamarter et al 1990).…”

Section: Discussionmentioning

confidence: 99%

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Treatment of High-Energy Tibial Plateau Fractures by the Ilizarov Circular Fixator

Dendrinos¹,

Kontos²,

Katsenis³

et al. 1996

The Journal of Bone and Joint Surgery. British volume

191

104

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All the fractures united, with an average time to healing of 14.4 weeks. Thirteen patients achieved full extension and 13 more than 110° of flexion. Twenty-two knees were stable. Fifteen patients walked normally and the rest with only a slight limp. All but two knees had an articular step-off of less than 4 mm and all had normal axial alignment except two. There were no cases of postoperative skin infection, osteomyelitis or septic arthritis.Ilizarov circular fixation is an ideal method of treatment for these fractures when extensive dissection and internal fixation are contraindicated due to trauma to the soft tissue, deficiency of bone stock, and bony comminution. [Br] 1996;78-B:710-7. Received 16 November 1995; Accepted after revision 15 February 1996 Bicondylar high-energy fractures are associated with severe articular depression, separation of both condyles, diaphyseal comminution and dissociation and loss of integrity of the soft-tissue envelope. They occur primarily in younger patients usually with multiple injuries. J Bone Joint SurgThe most popular treatment has been open reduction and internal fixation with double plating (Müller et al 1979;Schatzker, McBroom and Bruce 1979;Waddell, Johnston and Neidre 1981;Edwards 1983;Moore, Patzakis and Harvey 1987;Schatzker 1987; DeCoster, Nepola and ElKhoury 1988;Benirschke et al 1992;Tscherne and Lobenhoffer 1993;Watson 1994), but this is associated with many complications such as joint stiffness, malunion, skin loss, osteomyelitis, amputation and even death. The incidence has been as high as 50% in some studies (Rittman et al 1979;Perry et al 1984;Moore et al 1987;Schatzker 1987;Stokel and Sadesivan 1991) and the occurrence of postoperative skin infection and osteomyelitis has been reported as 42% and 33%, respectively (Uhl et al 1994). To reduce the incidence of such problems minimal internalexternal fixation through limited approaches has been attempted with some good results (Murphy, D'Ambrosia and Dabezies 1991; Tscherne and Lobenhoffer 1993;Carr 1994;Stamer et al 1994;Watson 1994).An alternative method was proposed by Ilizarov (Catagni 1991; Ilizarov 1992), and we have adopted his techniques for the treatment of fractures and nonunion (Dendrinos, Kontos and Lyritsis 1995;. In this prospective study we have used this method for the management of high-energy fractures of the tibial plateau. PATIENTS AND METHODSBetween October 1989 and July 1993 we treated 24 consecutive patients with severe bicondylar fractures of the tibial plateau by the Ilizarov fixator (Table I). They were reviewed at a minimum of 24 months and the level of function, clinical and radiological findings and the patients' opinion were assessed. There were 18 men and 6 women with a mean age of 39 years (18 to 69). Four patients were car drivers or passengers, eight were pedestrians struck by motor vehicles and seven were motor-cycle riders. Four had been injured by falls from a height and one had a crush injury caused by a collapsed wall. Eleven (46%) of the fractures were open. There we...

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Treatment of High-Energy Tibial Plateau Fractures by the Ilizarov Circular Fixator

Dendrinos¹,

Kontos²,

Katsenis³

et al. 1996

The Journal of Bone and Joint Surgery. British volume

191

104

View full text Add to dashboard Cite

show abstract

“…Delamarter et al 11 in their study of 39 patients found 28.20% to have poor results. This was due to the fact that all the patients selected in their study either had isolated ligament injury or combined ligament injuries associated with tibial plateau fracture which resulted in instability.…”

Section: Discussionmentioning

confidence: 87%

“…2). Final result were assessed using a 100-point rating system devised by Delamarter et al (Table I) and were graded as excellent (90-100 points), good (80-89 points), fair (70-79 points) or poor (< 70 points) 11,12 .…”

Section: Methodsmentioning

confidence: 99%

Prospective Study to compare Intra-articular versus Intravenous Tranexemic Acid in reducing Post-operative Blood Loss in staged bilateral Total Knee Arthroplasty

Balasubramanian¹,

GB²,

Prakasam³

2016

MOJ

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Introduction:Tibial plateau injury involves the articular surface of the proximal tibia with diverse group of fractures that represent a wide spectrum of severity that challenge even the most experienced surgeons, but with the invent of modern diagnostic technology and the advent of locking plates, results appear to be improving over time. Method: The study was conducted on thirty patients admitted in the department of orthopaedics with diagnoses of tibial plateau fractures treated with Locking Condylar Plate. The patients were followed up for a minimum period of six months and clinico-radiological progression of fracture union with the functional outcome was studied using 100 point rating system devised by Delamarter et al. Result: Twenty-two patients showed excellent results while eight patients had good to fair and none with poor result. The average time for radiological union was 17.5 weeks. Conclusion:The results of the study concluded that while locking condylar plate seems to show excellent results in low energy tibial plateau fractures, it can probably be used to successfully treat patients with high energy fracture patterns without the need for additional medial stabilization.

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“…9 Finally, the incidence of associated knee ligament injuries is also lower in the elderly, approximately 3%, compared to 20-25% in younger patients. 16,18 In comparison to younger patients, the outcome of tibial plateau fractures in patients over the age of 40 years is associated with poorer standardised health and disability ratings. 19 Schwartsman and co-workers drew attention to the problems related to patient self-assessment of treatment outcome and concluded that tibial plateau fractures in patients over the age of 50 years is likely to have an unsatisfactory objective outcome, even in the hands of experienced surgeons, regardless of the treatment method.…”

Section: Discussionmentioning

confidence: 99%

Circular external fixation in the management of tibial plateau fractures in patients over the age of 55 years

Marais

Ferreira

2018

SA orthop. j.

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Introduction: Tibial plateau fractures in the elderly pose significant treatment challenges because of coexisting medical problems, pre-existing degenerative joint disease and osteoporosis. While several studies have reported promising results with the use of circular external fixation, little data is available on its use in older patients. This study aims to compare the complications and union rate of circular external fixation in patients over the age of 55 years with that achieved in younger patients.

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Ligament Injuries Associated With Tibial Plateau Fractures

Cited by 141 publications

References 0 publications

Treatment of High-Energy Tibial Plateau Fractures by the Ilizarov Circular Fixator

Treatment of High-Energy Tibial Plateau Fractures by the Ilizarov Circular Fixator

Prospective Study to compare Intra-articular versus Intravenous Tranexemic Acid in reducing Post-operative Blood Loss in staged bilateral Total Knee Arthroplasty

Circular external fixation in the management of tibial plateau fractures in patients over the age of 55 years

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