Minimally Invasive Plate Osteosynthesis for Tibial Plateau Fractures

Raza, Hasnain; Hashmi, Pervaiz Mehmood; Abbas, Khawar; Hafeez, Kamran

doi:10.1177/230949901202000109

Cited by 30 publications

(27 citation statements)

References 28 publications

(40 reference statements)

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“…The mean duration of surgery in our series was 100 min which was comparable to 113 min by Hasnain et al [20] in 2012. In our series 82% of the patients were mobilized within 10 days of surgery and remaining 18% were kept protected until 3 weeks and gradual mobilization was started.…”

Section: Study Mean Delay B/w Injury and Surgery (Days)supporting

confidence: 82%

Comparison of outcome of unilateral plating and dual plating in treatment of bicondylar tibia plateau fractures

Modi¹,

Bishnoi²,

Vyas³

2017

Int. J. Orthop. Sci.

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Introduction: Fractures of the proximal tibia, particularly those that extend into the knee joint are termed as tibial plateau or tibial condylar fractures. It results from indirect coronal or direct axial compressive forces. Overall worldwide, it comprises of 1% of all fractures & 8% of the fractures in elderly. In the past two decades, with improvements in surgical techniques and implants, there has been a growing trend towards surgical management of these injuries. Thus we have advanced from the conservative approach to internal fixation in fractures as an acceptable mode of treatment. No proven uniform successful method of treatment. Nevertheless, tibial plateau fractures remain challenging because of their number, variety and complexity. Aim: To study the surgical management in terms of unilateral and dual plating for bicondylar intraarticular fractures of proximal tibia to obtain a stable, pain free, mobile joint, to prevent the development of osteoarthritis and to correlate the radiological findings with the type of fracture and the functional end result. Materials and Methods: This was a prospective study of 44 cases. All patients included in this study sustained tibial plateau fracture grade V and VI according to Schatzker Classification. We used Rasmussen's functional and radiological scoring system for the comparison of outcome of plating. In the surgical group 20 patients were treated by unilateral plating and 24 patients were with dual plating. These patients were followed up for an average period of 13 months. Results and discussion: In our study according to Rasmussens functional scoring 4 , we have achieved excellent outcome in 43%, good in 50%, fair in 7%, which is comparable to the standard studies. These studies suggest that while isolated lateral locked plating may offer a more biological approach to bicondylar fractures, and may provide a viable alternative for open fractures with a medial wound or fractures with tenous soft tissues, classical dual plating remains the most rigid construct. Conclusion: The surgical management of tibial bicoondylar fracture is challenging and dual plating gives excellent anatomical reduction and rigid fixation to restore articular congruity, facilitate early knee motion by reducing post-traumatic osteoarthritis and thus achieving optimal knee function.

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Section: Study Mean Delay B/w Injury and Surgery (Days)supporting

confidence: 82%

Comparison of outcome of unilateral plating and dual plating in treatment of bicondylar tibia plateau fractures

Modi¹,

Bishnoi²,

Vyas³

2017

Int. J. Orthop. Sci.

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“…Mitchell and Shepard point out precise intra-articular reduction and stable fixation of the fragments [10], while incorrect reduction and instability can cause rapid degeneration of the articular cartilage. Similarly, other studies reported requirement for anatomic reduction and stable fixation to achieve early mobilization and determinant of functional outcomes as postoperative ROM, joint stability and pain [11]- [13]. In addition sufficient cartilage nourishment is provided with stable fixation and early ROM [11].…”

Section: Introductionmentioning

confidence: 94%

Immediate Knee Joint Range of Motion after Stable Fixation of Tibial Plateau Fractures

Arslan¹,

Polat²,

Ciliz³

et al. 2015

OJO

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The purpose of this study was to evaluate factors that affect initiation of early postoperative range of motion (ROM) rehabilitation and to investigate whether the postoperative ROM and clinical outcomes were affected by initiation of early ROM, immobilization and other factors. We conducted a retrospective analysis of tibial plateau fractures treated using stable internal fixation between December 2003 and June 2007. The resulting degree of flexion and Rasmussen Clinical and Radiographic Scores were evaluated. Thirty-nine patients were included, and 23 patients underwent a lateral submeniscal arthrotomy for evaluation of joint surface reduction, with 6 lateral meniscus lesions identified via arthrotomy. Three lateral collateral ligament lesions, 3 medial collateral ligament lesions and 1 anterior cruciate ligament lesion were found. Meniscus and ligament lesions significantly and negatively affected the initiation of knee joint ROM. Early ROM was achieved in 26 cases and 13 patients underwent immobilization for 4 weeks. At the final evaluation, the early ROM group had 130.42˚ ± 5.50˚ of flexion, compared with 122.92˚ ± 5.28˚ in the immobilization group. Moreover, the final Rasmussen score was 25.69 ± 2.92 in the early motion group, compared with 22.61 ± 3.5 in the immobilization group. There was no difference between radiographic scores of the groups. Although the initiation of early ROM improved the clinical results, soft tissue lesions influenced initiation of early knee joint motion. Therefore, meniscus and ligament injuries should be considered as prognostic factors in similar cases.

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“…The rate of infection was 7.7% (n=2) and H Raza series [6] has 2.4%(n=1) infection. All the infections were superficial infection and healed with time and antibiotics.…”

Section: Complicationsmentioning

confidence: 91%

“…"Favourable outcome is due to less extensive dissection of soft tissue envelope and de vitalization of fracture fragments." [6] Posttraumatic osteoarthritis was seen in 9.2% (n = 4) of the 42 patients managed surgically. In this study the incidence of secondary arthritis was more common in type IV and VI injuries.…”

Section: Complicationsmentioning

confidence: 98%

“…The prognostic factors for condylar tibia fracture include age, intra articular involvement, method of treatment, timing of joint mobilization etc. Multiple articles have been published documenting superior functional results using internal fixation (Nabil series, [2] H Raza series, [6] R Sament series [5] ). The result and observation of the present study is compared with the other similar studies which are depicted in tables.…”

Section: Complicationsmentioning

confidence: 99%

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Outcome of Management of Closed Proximal Tibia Fractures in Tertiary Hospital of Surat

Mehta¹,

Prashanth²,

Siddiqui³

2015

jemds

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BACKGROUND: Proximal tibia fractures are complex injuries associated with a high incidence of soft tissue complications. Management of it varies with the type of fracture and its outcome requires an aggressive approach towards patient, so study was conducted to assess the outcome of closed proximal tibia fracture management. AIM AND OBJECTIVES: To evaluate the outcome of various treatment modalities in tibial condylar fractures and to study the advantages and disadvantages of surgical treatment. comparing treatment modalities and finding management strategies, depending on type and displacement of fractures. STUDY DESIGN: Prospective type. MATERIALS AND METHODS: 50 consecutive closed tibial plateau fractures were included in this study. All fractures were classified according to Schatzker classification. There were 41 men and 9 women. The study was conducted between August 2010 and October 2012 at the Department of Orthopaedics, New Civil hospital, Surat after the Ethical committee approval. The final outcome was assessed using the Rasmussen's score. The results were analyzed using different parameters; male vs. female, age distribution, mode of trauma, functional outcomes and complications etc. RESULTS AND CONCLUSION: The average age was 40.52 years with the fracture being more common in the 3 rd to 5 th decades. Same number of patients had fracture of either limb. 68 % sustained fracture due to road traffic accident. 84% of the patients had Schatzker type I, IV and type V fractures. The average time of interval for fracture union was 3.87 months in case of conservative (n=8) method and 3.33 months in CR -IF (n=16) with cannulated screws and 3.81 months for OR -IF (n=26) with buttress plating. Thus, the average time of union for CR-IF was shorter than for OR-IF which shows the importance of preserving fracture site haematoma. 3 patients had infections and loss of reductions each,1 peroneal nerve injury, 3 knee stiffness, 4 osteoarthritis and 1 malunion with no non-union.

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Minimally Invasive Plate Osteosynthesis for Tibial Plateau Fractures

Cited by 30 publications

References 28 publications

Comparison of outcome of unilateral plating and dual plating in treatment of bicondylar tibia plateau fractures

Comparison of outcome of unilateral plating and dual plating in treatment of bicondylar tibia plateau fractures

Immediate Knee Joint Range of Motion after Stable Fixation of Tibial Plateau Fractures

Outcome of Management of Closed Proximal Tibia Fractures in Tertiary Hospital of Surat

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