The Relationship between the Injury Mechanism and the Incidence of ACL Avulsions in Schatzker Type IV Tibial Plateau Fractures: A 3D Quantitative Analysis Based on Mimics Software

Liu, Zihao; Wang, Shuai; Tian, Xiaochen; Peng, Aqin

doi:10.1055/s-0041-1740929

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…Flexion-valgus pattern was the main cause of Schatzker type IV fractures associated with ACL avulsions. The findings will help orthopaedic surgeons understand the injury mechanism and augment their awareness of such injuries to avoid unfavourable prognosis (117).…”

Section: Residual Knee Instability Secondary To Ligaments Damage That...mentioning

confidence: 96%

“…Medial collateral ligament injury was the most common in the Schatzker type 2 (50% of the injuries) (116). According to Lin et al, tibial plateau fractures are often accompanied by ligamental and meniscal injuries (117). Among these, the combined existence of Schatzker type IV fracture with ACL avulsion has been published rarely.…”

Section: Residual Knee Instability Secondary To Ligaments Damage That...mentioning

confidence: 99%

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Complications of the surgical treatment of fractures of the tibial plateau: prevalence, causes, and management

2022

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Open reduction and internal fixation is the gold standard treatment for tibial plateau fractures. However, the procedure is not free of complications such as knee stiffness, acute infection, chronic infection (osteomyelitis), malunion, non-union, and post-traumatic osteoarthritis. The treatment options for knee stiffness are mobilisation under anaesthesia (MUA) when the duration is less than 3 months, arthroscopic release when the duration is between 3 and 6 months, and open release for refractory cases or cases lasting more than 6 months. Early arthroscopic release can be associated with MUA. Regarding treatment of acute infection, if the fracture has healed, the hardware can be removed, and lavage and debridement can be performed along with antibiotic therapy. If the fracture has not healed, the hardware is retained, and lavage, debridement, and antibiotic therapy are performed (sometimes more than once until the fracture heals). Fracture stability is important not only for healing but also for resolving the infection. In cases of osteomyelitis, treatment should be performed in stages: aggressive debridement of devitalised tissue and bone, antibiotic spacing and temporary external fixation until the infection is resolved (first stage), followed by definitive surgery with grafting or soft tissue coverage depending on the bone defect (second stage). Intra-articular or extra-articular osteotomy is a good option to correct malunion in young, active patients without significant joint damage. When malunion is associated with extensive joint involvement or the initial cartilage damage has resulted in knee osteoarthritis, the surgical option is total knee arthroplasty.

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Section: Residual Knee Instability Secondary To Ligaments Damage That...mentioning

confidence: 96%

Section: Residual Knee Instability Secondary To Ligaments Damage That...mentioning

confidence: 99%

Complications of the surgical treatment of fractures of the tibial plateau: prevalence, causes, and management

2022

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“…The injury mechanism of tibial plateau fractures drew limited attention in previous studies 23 . Several literature had discussed the treatment or classi cation of tibial plateau fractures involving the injury mechanism, but the relevant content were oversimpli ed [15][16][17][18] .…”

Section: Discussionmentioning

confidence: 99%

Introduction of 3D-classification and its derived surgical sequence of Schatzker type IV tibial plateau fractures

Liu

Wang

Wang³

et al. 2023

Preprint

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Introduction Schatzker IV tibial plateau fractures usually have worse prognosis due to its high variability and the combination of bony and soft tissue injuries. The aim of this study was to introduce a new classification of Schatzker IV tibial plateau fractures based on the injury mechanism and evaluate its reliability. The secondary aim was to evaluate the outcomes of operative Schatzker IV tibial plateau fractures treated according to the surgical sequences which were determined by the new classification. Materials and Methods 63 operative Schatzker IV tibial plateau fractures which were treated following the new surgical sequence were enrolled in our study. CT images of these patients were reviewed and classified twice according to our new classification by four observers. The reliability of the classification was calculated by application of kappa analysis. The surgical sequence determined by the classification was evaluated by observing the the postoperative efficacy during the follow-up. Results The intra-observer reliability of 3D-classification showed excellent agreement according to Landis and Koch (The mean k = 0.897, CI 0.806–0.971). And the inter-obsever reliability of 3D-classification also showed excellent agreement. (The mean k = 0.883, CI 0.786–0.961). All patients were followed up and the average follow-up of the cases was 12.8 months (6–28 months). As for the evaluation of the postoperative efficacy, according to KSS, 53 cases were rated as excellent, 8 cases were rated as good and 2 cases were considered as fair results. Conclusions The new proposed classification showed high intra and inter-observer reliability in our study. And the surgical sequence determined by the classification can help surgeons to acquire good reduction and rigid internal fixation. Therefore the new classification of Schatzker IV tibial plateau fractures and the accompanied surgical sequence are worthy of further popularization and application in clinical trials.

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“…MRI has been neglected as a tool in the evaluation of tibial plateau fractures. Recent studies have demonstrated its values in determining the mechanism of injury [ 70,71 ]. Modern Magnetic Resonance machines are capable not only to provide imaging of the soft tissue detail of the injury but will also provide information on the amount of damage to the cartilage and a surprising detail of associated bony injury.…”

Section: Discussionmentioning

confidence: 99%

Revisiting the management of tibial plateau fractures

Schatzker

Kfuri

2022

Injury

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The Relationship between the Injury Mechanism and the Incidence of ACL Avulsions in Schatzker Type IV Tibial Plateau Fractures: A 3D Quantitative Analysis Based on Mimics Software

Cited by 4 publications

References 22 publications

Complications of the surgical treatment of fractures of the tibial plateau: prevalence, causes, and management

Complications of the surgical treatment of fractures of the tibial plateau: prevalence, causes, and management

Introduction of 3D-classification and its derived surgical sequence of Schatzker type IV tibial plateau fractures

Revisiting the management of tibial plateau fractures

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