New Developments in Treatments of Tibial Plateau Fractures

Liu, Yake; Zhou, Zhenyu; Liu, Fan

doi:10.4103/0366-6999.217085

Cited by 4 publications

(5 citation statements)

References 21 publications

(28 reference statements)

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“…Literature search [17–19] and retrospective analysis of clinical patients in our hospital revealed that the common reasons for the surgical failure of complex tibial plateau fractures were inadequate experience of the surgeon regarding the diagnosis and treatment, inaccurate selection of implants, and imperfect surgical techniques.…”

Section: Discussionmentioning

confidence: 99%

“…Surgeons need to have a correct understanding of the characteristics and types of the fractures as these are the key information for successful surgical management of complex tibial plateau fractures. As a result, we should make the full use of X-rays and CT scans to obtain the stereo image of the fracture and to clarify the complicated fracture lines and multiplanar displacement of the fracture fragments in order to make a more accurate evaluation of the fracture [4, 19].…”

Section: Discussionmentioning

confidence: 99%

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Failure analysis of primary surgery and therapeutic strategy of revision surgery for complex tibial plateau fractures

Song

Wang

et al. 2019

J Orthop Surg Res

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Purpose To analyze the cause of failure of the primary surgery for complex tibial plateau fractures and to define the therapeutic strategy of the revision surgery for the same. Methods Twenty-one cases with failure of primary surgery for complex tibial plateau fractures were treated in our hospital from January 2012 to September 2016. There were 13 males and 8 females with an average age of 39.4 years (ranged between 27 and 58 years). Patients presented with different types of complex tibial plateau fractures like Schatzker type V ( n =9), VI ( n =12), type 41.C1 ( n =9), type 41.C2 ( n =6), and type 41.C3 ( n =6). The therapeutic strategy for revision surgery in individual patients was decided following careful analysis and accurate assessment of the causes of failure of the primary surgery. All the patients were followed-up with Rasmussen radiographic scores and Hospital for Special Surgery (HSS) knee scores. Results All 21 patients underwent clinical and radiological examination after a mean follow-up time of 32.6 months. The average time of fracture healing was 4.5 months (ranged between 3 and 6 months). During the last follow-up, the mean range of motion of knee extension was 2.3° and knee flexion was 123.8°. The mean radiological Rasmussen score was 15.6 points, with an overall success rate of 85.7%. The average HSS knee score was 84.3 points, with an overall success rate of 80.9%. Conclusion The common reasons for the failure of primary surgery of complex tibial plateau fractures were inadequate experience of the surgeon, inaccurate diagnosis and management, improper selection of implants, and poor surgical techniques. The key factors to succeed revision surgery were adequate preoperative evaluation, accurate intraoperative procedures, and proper postoperative rehabilitation. Level of evidence Level IV, case series, treatment study

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Failure analysis of primary surgery and therapeutic strategy of revision surgery for complex tibial plateau fractures

Song

Wang

et al. 2019

J Orthop Surg Res

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“…Koval et al described use of direct elevation of the depressed fragment through the fracture site using open book approach for schatzker type 2 fractures, they also described using a window from the opposite cortex for elevating the tilted fragment. The main objectives when treating articular fractures of the knee are the restoration of articular congruity and stability, the axial and rotational alignment of the lower limb and stability and early motion of joint [22] . The author used bone locking and non-locking constructs for fixation.…”

Section: Discussionmentioning

confidence: 99%

Types of depression in intraarticular tibial condylar fractures and modes of elevation: A retrospective series of 950 cases

Chandak¹,

Sharma²,

Ramteke³

et al. 2021

Int. J. Orthop. Sci.

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Background: Tibial condylar fractures are often associated with depression of articular surface and commonly used classifications describe various fracture patterns. However, these classifications do not address the types of depression of articular fragments, so we tried to classify various types of depressions of articular surface associated with tibial condylar fractures and developed a treatment algorithm based on our study, with an aim to facilitate step-wise approach for classifying and modes of elevation of depressed fragments. Material and Methods: This was an intervention study of 950 tibial condylar fractures operated at our center by single surgeon between March 2002-2016. These patients were retrospectively evaluated for radiographic and functional outcomes. Results:The study revealed mean post op condylar tilt of 5.38 ±3.55, (0-12), condylar widening of 2.68 ±1.25 (0-6mm), articular step 2.98±1.86 (0-8mm), valgus tilt 6.64±3, (0-13) and mean knee society score of 84.39±6.3, (60-98) at follow-up of 12 months post-op. All the cases were followed up for at least 24 months, mean follow-up time 87.39  35. 97 months (7.25+2.91 years).The average radiographic bony union time was 17.07 ±1.4, (14-22wks) weeks, the average full weight bearing time was 15.04 ±2, (12-24) weeks. The average range of motion of the affected knees at 12 months was 127. 6±4.46, (120-135). Conclusion: Based on our study of the various types of depression of articular surface in tibial condylar fractures, we were able to classify depression, facilitate steps of surgery and improving outcomes.

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“…In 8 the average age of the patients was 35.5 years (range 21-50 years) with male to female ratio of 11.5: 1. Hence, proximal tibial fractures were seen in younger and middle aged population.…”

Section: Age and Sex Incidencementioning

confidence: 99%

“…The management of tibial plateau fracture has been controversial and the objective of stable, pain free knee joint with a good functional range of motion as well as good radiological restoration of tibial articular surface of knee joint eluded most of the management modalities. 8 Among the different options available, the surgical methods most commonly in use are plating, C.C. screws as treatment modalities for internal fixation and hybrid external fixation.…”

Section: Introductionmentioning

confidence: 99%

Study of functional outcome of tibial plateau fractures treated with anatomical contoured locking compression plate

Mukherjee¹,

Vadadoriya²,

Chatterjee³

et al. 2021

IJOS

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Tibial plateau fractures tend to occur in patients with polytrauma and in elderly patients with history of significant fall. This study was undertaken to evaluate and explore new generation implant fixation in tibial plateau fractures which is expected to provide a stable fixation with minimum exposure, early mobilization, less complications and a better quality of life.About 43 cases who had sustained tibial plateau fractures (Schatzker type I-VI) and operated with anatomical contoured locking compression plate were included. Follow-up of these patients was done at 6 weeks, 3 months, and 6 months after surgery. We analyzed all our subjects using IKDC score for functional outcome and plateau depression measurement for radiological outcome at 3 months and 6 months.All the 43 fractures analysed in this study were graded in accordance to the Schatzker classification. It was observed that most of these fractures, i.e., 16 out of 43 (37.2%) were type VI and 13 out of 43 (30.2%) type V. The average knee flexion at 3 months was 105.7±8.49 degrees and at 6 months 120.6±8.61 degrees. After evaluation, it was observed that at 6 months, 3 patients had extension lag (7%) out total 43 patients. Most of the patients had average IKDC score of 80.2±7.91% at 3 months which increased to average 86.92±8.05% at 6 months.Achieving and maintaining anatomical reduction becomes easy with advanced design of these plates, which helps in early mobilization and hence obtaining good functional and radiological outcomes of tibial plateau fractures.

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New Developments in Treatments of Tibial Plateau Fractures

Cited by 4 publications

References 21 publications

Failure analysis of primary surgery and therapeutic strategy of revision surgery for complex tibial plateau fractures

Failure analysis of primary surgery and therapeutic strategy of revision surgery for complex tibial plateau fractures

Types of depression in intraarticular tibial condylar fractures and modes of elevation: A retrospective series of 950 cases

Study of functional outcome of tibial plateau fractures treated with anatomical contoured locking compression plate

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