Percutaneous fixation of tibial plateau fractures under arthroscopy: A medium term perspective

Siegler, J.; Galissier, B.; Marcheix, Pierre-Sylvain; Charissoux, J.-L.; Mabit, C.; Arnaud, J.

doi:10.1016/j.otsr.2010.08.005

“…The incidence of knee instability in our study was 11% as compared with 12% by Pawar et al [26] in 2012. The incidence of restricted knee motion in the form of extensor lag and knee stiffness in our study was 23% and 13% respectively as compared with 16% and 12% by Pawar et al [26] in 2012, 0% and 5% by F. Biggi et al [24] in 2010, 0% and 10% by J. Siegler et al [25] in 2011. There was no incidence off compartment syndrome, deep vein thrombosis or nerve palsy observed in our study.…”

Section: Our Seriescontrasting

confidence: 42%

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

Modi¹,

Bishnoi²,

Vyas³

2017

Int. J. Orthop. Sci.

0

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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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“…[ Incidence of redepression was very high in our study, in 15 cases (34%) out of which 10 cases in unilateral plating as compared to 18.4% with Nikolaos et al [17] in 2010, 19.4% with J. Siegler et al [25] in 2011. Malunion in the form of varus or valgus were observed in 11 cases (25%,9-varus and 1-valgus) as compared with 0% by of Mathur et al [16] in 2005, 2% by Ebraheim et al [19] in 2004, 9.6% by Nikolaos et al [17] in 2010, 2% by F. Biggi et al [24] in 2010.…”

Section: Our Seriesmentioning

confidence: 46%

Untitled

2017

Int. J. Orthop. Sci.

0

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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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“…Finally, 20 papers remained for analysis, of which 17 were in English, 2 in Chinese and 1 in Korean 8,11,13,14,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] . Specifically, there were 2 prospective comparative studies, 2 retrospective comparative studies, 15 case series, and 1 clinical series based on a technique note 8,11,13,14,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] . Levels of evidence (levels I-IV) for each study were examined and distinguished according to the content developed by the OCEBM (15) 6.0 AE1.8 Selection process (15) 11.9 AE2.6 Total score (100) 58.7 AE10…”

Section: Literature Search and Quality Assessmentmentioning

confidence: 99%

“…Specifically, there were 2 Level II studies, 2 Level III studies, and 16 Level IV studies 8,11,13,14,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] . Although 3 studies included a minority (<25%) of patients with complex or bicondylar fractures and should not be included in this review according to the exclusion criteria, the third reviewer finally decided to include these studies considering the fact that the clinical or radiological outcomes of each patient were specifically listed and the data of patients with monocondylar fractures could, therefore, be extracted for analysis 23,26,34 .…”

Section: Literature Search and Quality Assessmentmentioning

confidence: 99%

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Percutaneous Reduction and Internal Fixation for Monocondylar Fractures of Tibial Plateau: A Systematic Review

Chang

¹

,

Yu

²

,

Ju

³

et al. 2018

Orthopaedic Surgery

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Instead of extensive dissection of soft tissue around the fracture site, percutaneous techniques have unique advantages in managing displaced fragments, including preservation of soft tissues, less blood loss, lower risk of complications, and earlier functional rehabilitation. However, there are few systematic reviews on the effects of percutaneous reduction and internal fixation (PRIF) for tibial plateau fractures. A systematic search of Cochrane, EMBASE, and MED-LINE databases was performed for all publicly available data in March 2017 regarding the use of PRIF in treating monocondylar tibial plateau fractures. Basic information of included articles, surgical information, clinical outcomes, and concomitant soft tissue injuries were collected for analysis. Finally, a total of 20 articles including 561 patients were retrieved. Traffic accident was the most common cause of injury. Percutaneous techniques using bone tamp reduction were described in all studies. The majority (≥85%) of patients were classified as excellent or good according to clinical and radiological Rasmussen scores. The overall complication rate was 6.6%, with loss of reduction the most frequent complication with an incidence of 2.4%. This systematic review indicated that PRIF was an optimal alternative that physicians should consider for the treatment of monocondylar tibial plateau fractures.

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Percutaneous fixation of tibial plateau fractures under arthroscopy: A medium term perspective

Abstract: Level IV. Retrospective study.

Cited by 61 publications

References 16 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

Untitled

Percutaneous Reduction and Internal Fixation for Monocondylar Fractures of Tibial Plateau: A Systematic Review

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