Treatment of tibial plateau fractures: A comparison of two different operation strategies with medium-term follow up

Wang, Zhongzheng; Zheng, Zhong; Ye, Pengyu; Tian, Siyu; Zhu, Yanbin; Chen, Wei; Hou, Zhiyong; Zhang, Qi; Zhang, Yingze

doi:10.1016/j.jot.2022.06.005

Cited by 9 publications

(4 citation statements)

References 24 publications

(40 reference statements)

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“…Research indicates that bilateral incision approaches can avoid relatively weak areas of the anterior tibial soft tissue, reducing extensive detachment of soft tissue at the fracture site. This helps to ensure optimal blood supply to the fracture site, greatly reducing the incidence of postoperative complications [12]. Moreover, literature supports that this surgical approach provides su cient operating space, enabling simultaneous treatment for concomitant knee joint soft tissue injuries, such as those to the cruciate ligament, collateral ligament, and meniscus, resulting in satisfactory clinical outcomes [13].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the bilateral dual plate internal fixation technique for rotationally dislocated tibial plateau fractures

Tang,

Zhang,

et al. 2023

Preprint

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Purpose This study aims to explore the clinical efficacy of dual plate internal fixation through a bilateral approach for the treatment of rotationally dislocated tibial plateau fractures. Methods Clinical data of 20 patients (6 male, 14 female) with rotational dislocation type tibial flat fractures treated from January 2020 to April 2022 were retrospectively analyzed. Out of all fractures, 12 occurred on the right side, and 8 on the left side. The average age of the patients was 51.9 ± 13.11 years. All patients underwent surgical treatment using the bilateral approach with dual plate internal fixation, and the related surgical indicators were recorded. After surgery, data such as fracture line disappearance time (in months), tibial plateau varus angle (TPA), tibial plateau posterior angle (PA), joint range of motion (ROM), New York Hospital for Special Surgery Hospital (HSS) knee joint function score, Rasmussen score, visual analog scale (VAS) score for pain, and Fugl–Meyer motor function assessment (FMA) score were recorded, along with the incidence of postoperative complications. Results All patients were followed up for 13.55 ± 9.75 months. The average time for the disappearance of the patients’ fracture line was 3.75 ± 0.91 months. Comparisons of TPA, PA, ROM, HSS score, Rasmussen score, and VAS score at immediately and 3 month after surgery, as well as 6 and 12 months after surgery. The research results revealed that there is a statistically significant differences (P < 0.05) between 3, 6, and 12 months after surgery and immediately after surgery. The FMA score indicated an excellent and good rate of 80% at 12 months after surgery. Postoperative complications included superficial skin infection at the incision in 2 (10.0%) cases, delayed union of fractures in 2 (10%) cases, limited mobility in 1 (5.0%) case, knee instability in 2 (10.0%) cases, and traumatic arthritis in 4 (20%) cases. Conclusion The bilateral approach involving dual plate internal fixation was used to treat rotational dislocation tibial plateau fractures. This technique has the advantages of fast intraoperative reduction, high stability of internal fixation, fewer postoperative complications, and good recovery of knee joint function, proving its potential as an effective and safe treatment method.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the bilateral dual plate internal fixation technique for rotationally dislocated tibial plateau fractures

Tang,

Zhang,

et al. 2023

Preprint

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“…A higher score on this scale shows inferior outcomes. This scale has been widely approved for the Iranian population in terms of reliability and validity [ 13 , 14 ].…”

Section: Methodsmentioning

confidence: 99%

“…The most common treatment method for TPF is ORIF performed by plates and screws, which has been associated with acceptable clinical results. However, this method is associated with complications, the most important of which are: excessive bone damage and soft tissue damage, high risk of infection, and functional rehabilitation problems with delayed activity and scar formation [ 12 , 13 ]. Another treatment method for these patients is closed reduction and plastering, which is not recommended for adults due to the difficulty of maintaining the reduction in plaster and the possibility of complications such as malunion.…”

Section: Introductionmentioning

confidence: 99%

Functional outcomes and quality of life after surgically treated tibial plateau fractures

et al. 2023

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Background Tibial plateau fractures (TPF) are uncommon and challenging for orthopedic surgeons with controversial reported outcomes. In this study, we aimed to evaluate the functional outcomes and quality of life (QOL) of patients with surgically treated TPF. Methods A total of 80 consecutive patients and 82 controls participated in this case control study. The patients were all surgically treated in our tertiary center from April 2012 to April 2020. The functional outcome was evaluated using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) scale. Moreover, we used the Short Form 36 health survey (SF-36) health survey to evaluate the QOL. Results No significant difference was observed in the overall mean SF-36 score in the two groups. We found a significant positive correlation between the scores of the SF-36 and WOMAC questionnaires (r = 0.642, p < 0.001) and between the ROM and the WOMAC questionnaire score (r = 0.478, p < 0.001). Further, ROM and SF-36 showed a weak positive correlation (r = 0.248, p = 0.026). Age had a weak negative correlation with the pain subscale of SF-36 (r = − 0.255, p = 0.22), even though it was not correlated with the total score or other subscales (p > 0.05). Conclusion QoL after TPF is not significantly different from that of a matched control group. Also, neither age nor BMI correlates with the QoL and functional outcome.

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“…Since this is highly consistent with the mechanical axis of the limbs, and the traction force of the joints and soft tissue and the natural axis of the human body are used for reduction, the reduction quality is significantly improved, and its traction force is also significantly enhanced ( 9 ). Current studies indicated that DRTR enjoyed significant advantages, such as its continuous and stable reduction effect and simple operation, compared with TT in treatment of unstable femoral intertrochanteric fractures ( 8 , 10 ), femoral shaft fractures ( 9 ), distal femur fractures ( 11 ) and tibial plateau fractures ( 12 ), which has attracted extensive attention from orthopedic doctors. However, the clinical safety and efficacy of DRTR in treatment of elderly patients with unstable intertrochanteric fractures remains unknown.…”

Section: Introductionmentioning

confidence: 99%

The clinical efficacy and safety of double reverse traction repositor and traction table in the reduction of unstable intertrochanteric fractures in elderly patients: a retrospective comparative study

Cao¹,

Xie²,

Hu³

et al. 2022

Ann Transl Med

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Background: Currently, we found that double reverse traction repositor (DRTR) is a treatment with operation convenience and fast in our clinical work. However, the clinical efficacy and safety of DRTR in the reduction of unstable intertrochanteric fractures in elderly patients remain unknown. Therefore, the study aimed to compare the clinical efficacy and safety of DRTR and traction table (TT) in the reduction of unstable intertrochanteric fractures in elderly patients. Methods: From October 2018 to December 2020, the elderly patients with unstable intertrochanteric fractures were reviewed. 22 patients treated with TT and 20 patients treated with DRTR met the inclusion criteria of this study, and baseline clinical characteristics were recorded. The reduction time, operation time, incision length and intraoperative blood loss were reviewed. The safety outcome was assessed by postoperative complications, and the efficacy outcomes were evaluated by the fracture healing time based on the radiographs conducted at each follow-up (1, 3, 6, 12 months after surgery) and hip function (hip flexion, Harris Hip Score) at the final follow-up (12 months after surgery).Results: There were no significant differences in terms of demographics and fracture characteristics of cases enrolled. In DRTR group, the average intraoperative reduction time [(34.8±7.6) min] and the average operation time [(87.1±12.2) min] were superior to those [(56.6±9.3); (123.1±15.0) min] in TT group (P<0.0001). However, there were no statistical significance in terms of the average incision lengths [(6.4±0.9) vs. (6.8±1.1) cm; P=0.1619], , the average intraoperative blood loss [(152.6±22.9) vs. (146.8±20.7) mL; P=0.3941], the average fracture healing times [(13.8±1.5) vs. (14.4±1.8) weeks; P=0.2350] and the average Harris hip score a year after operation [(84.4±6.6) vs. (82.7±7.2); P=0.4496] between the two groups. One patient in TT group experienced lower extremity intermuscular venous thrombosis postoperatively. No other operation-related complications were observed postoperatively nor during follow-up. Conclusions: Minimally invasive reduction with DRTR in unstable intertrochanteric fractures could effectively shorten the intraoperative reduction time and operation time in this study. Therefore, minimally invasive reduction with DRTR might be a good choice for intertrochanteric reduction of unstable intertrochanteric fractures.

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Treatment of tibial plateau fractures: A comparison of two different operation strategies with medium-term follow up

Cited by 9 publications

References 24 publications

Evaluation of the bilateral dual plate internal fixation technique for rotationally dislocated tibial plateau fractures

Evaluation of the bilateral dual plate internal fixation technique for rotationally dislocated tibial plateau fractures

Functional outcomes and quality of life after surgically treated tibial plateau fractures

The clinical efficacy and safety of double reverse traction repositor and traction table in the reduction of unstable intertrochanteric fractures in elderly patients: a retrospective comparative study

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