Outcome analysis of tibial plateau fractures fixed by single lateral periarticular locking plate

  • Maravi D.S. Professor
  • Ganvir A. Assistant Professor
  • Gaur S. Professor and Head
Keywords: Tibial plateau fractures, Schatzker classification, Locking compression plate, Rasmussen knee score

Abstract

Introduction: Tibial plateau fractures comprises of 1% of all fractures and 8% of fractures in the elderly.The severity of injury increases classified by schatzker classification. Intraarticular tibial bicondylar fractures are notoriously difficult to treat. Nowadays locking plate technology has allowed for a new approach to this difficult fracture.

Material and methods: This was a prospective study of 47 patients with tibial plateau fractures fixed with single lateral periarticular locking plate over lateral surface of tibia and followed upto 1year and evaluated by using Rasmussen knee score system.

Results: All patients were followed properly but three patients were lost to follow up so only remaining 44 patients were evaluated.at 1 year of follow up functional outcome was assessed and observed that 79.54% of patients had good to excellent results while 20.45% patients had fair results.

Conclusions: Tibial plateau articular fractures demands anatomical reduction and absolute stability to enhance the healing of articular fragments and make early motion possible .Periarticular locking plates combined with biological techniques have improved outcome with respect to union rate and decrease soft tissue complications.

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References

Koval KJZ, Joseph D. Handbook of fractures. 3rd ed. Philadelphia; Lippincott Williams &Wilkins ; 2006.

Schatzker J, Mc Broom R, Bruce D. The tibial plateau fractures. The Toronto experience 1975. ClinOrthopRelat Res.1978;(138):94-104.

Watson JT: High-energy fractures of the tibial plateau. OrthopClin North Am 1994; 25:723-752.

Watson JT, Schatzker J. Tibial plateau fractures. In: Browner B, Jupiter JB, Levine Am, Trafton PG, eds. Skeletal Trauma, 3rd ed. Philadelphia PA: WB Saunders;2003;2074-2130.

Ahearn N, Oppy A, Halliday R, Rowett-Harris J, Morris SA, Chesses TJ. et al. The outcome following fixation of bicondylartibial plateau fractures. Bone Joint J 2014; 96-b:956-62.

Mills WJ, NorkSE : Open reduction and internal fixation of high-energy tibial plateau fractures. OrthopClin North Am 2002;33:177-198.

Musahl V, Tarkin I, Kobbe P, Tzioupis PC, Siska A, Pape H. New trends and technique in open reduction and internal fixation of fractures of tibial plateau. J Bone Joint Surg [Br] 2009;91-B: 426-33.

Gosling T, Schandelmaier P, Marti A, Hunter T, Partenheimer A, Krettek C. Less invasive stabilization of complex tibial plateau fractures: a biomechanicical evaluation of a unilateral locked screw plate and double plating. J Orthop Trauma. 2004;18(8):546551.

Gosling T, Schandelmaier P, Muller M, Hankemeier S, Wagner M, Krettek C. Single lateral locked screw plating of bicondylartibial plateau fractures. ClinOrthopRelat Res. 2005;(439):207-214.

Schtz M, Kaaab MJ, Hass N. Stabilization of proximal tibial fractures with the LIS: System: early clinical experience in Berlin. Injury 2003;34(Suppl 1): A30A34.

Stannard JP, Wilson TC, Volgas DA, Alonso JE. The less invasive stabilization system in the treatment ofcomplex fractures of the tibial plateau: Short term result. J Orthop Trauma 2004;18(8):552-558.

Dias JJ, Stirling AJ, Finlay DBL, Gregg PJ. Computerized tomography for tibial plateau fractures. J Bone Joint Surg[Br].1987;69-B:84-88.

Zura RD, Adams SB, Jeray KJ, Obremskey WT , Stinnelt SS, Olsar SA. Timing of definitive fixation of severe tibial plateau fractures with compartment syndrome does not have an effect on the rate of infection. J Trauma. 2010;69:1523-26.

Anglen J, Kyre RF, Marsh JL, Virkus WW, Watter WC, Keith MW et al. Locking plates for extremity fractures. J Am AcadOrthop Surg.2009;17:465-72.

Gustillo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am. 1976;58:453-458.

Rasmussen P. Tibial condylar fractures: impairement of knee joint stability as an indication for surgical treatment . J Bone Joint Surg [Am] 1973;55-A:133150.

Weiner LS, Kelley M, Yang E, Steuer J, Watnick N, Evans M, Bergman M. The use of combination internal fixation and hybrid external fixation in severe proximal tibia fractures. J Orthop Trauma 1995;9:244-250.

Mallik AR, Covall DJ, Whitelaw GP. Internal versus external fixation of bicondylartibial plateau fractures. Orthop Rev 1993;21:1433-36.

Phisitkul P. McKinley TO, Nepola JV et al. Complication of locking plate fixation in complex proximal tibia injuries. J Ortho Trauma 2007;21:83-9.

Ricci WM, Rudzki JR, Borrelli J Jr. Treatment of complex proximal tibia fractures with the less invasive skeletal stabilization system. J Orthop Trauma 2004;18:521-7.

Nikolaou VS, Tan HB, Haidukewych G et al. Proximal tibial fractures ; early experience using polyaxial locking-plate technology. IntOrthop 2011;35:121521.

Liu F, Tao R, Cao Y et al. The role of LISS (less invasive stabilization system) in the treatment of periknee fractures. Injury 2009;40;1187-94.

Beck M, Gradl G, Gierer P et al. Treatment of complicated proximal segmental tibia fractures with the less invasive stabilization locking plate system. Unfallchirurg 2008;111:493-8.

Krettek C, Gerich T, Miclau T. A minimally invasive medial approach for proximal tibial fractures. Injury 2001;32(S 3):4-13.

Rademakers MV, Kerhoffs GMMJ, Sierevelt IN, Raaymakers ELFB, Marti RK. Operative treatment of 109 tibial plateau fractures : Five to 27 years follow up results. J Orthop Trauma 2007;21(1):5-10.

Andrews JR, Tedder JL, Godbout BP. Bicondylartibial plateau fractures complicated by compartment syndrome. Orthop Rev 1992;3:317-319.

Blake R, Watson JT, Morandi M. Treatment of complex tibial plateau fractures with the ilizarov external fixator. J Orthop Trauma 1993;7:167-168.

Blokker CP, Rorabeck CH, Bourne RB. Tibial plateau fractures. An analysis of the result of treatment in 60 patients.ClinOrthop 1983;182:193-199.

King GJW, Schatzker J. Case Report- Nonunion of a complex tibial plateau fractures. J Orthop Trauma 1991;2:209-212.

Stokel EA, Sadesvian KK. Tibial plateau fractures standardized evaluation of operative result. Orthopaedics 1991;14;263-270.

Tscherne H, LobenhofferP . Tibial plateau fractures . Management and expected results. ClinOrthop 1993;292:87-100.

Waddell JP, Johnston DWC, Neidre A. Fractures of the tibial plateau: a revive of ninety -five patients and comparison of treatment methods. J Trauma 1981;21:376-380.

Young MJ, Barrack RL. Complication of internbal fixation of tibial plateau fractures. Orthop Rev 1994;23:149-154.

Lee JA, Stamatios A. Papadakis , Moon C, Zalavras CG. Tibial plateau fractures treated with the less invasive stabilization system. IntOrthop 2007 June;31(3):415-18.

Haidukkewych G, Sems SA, Huebner D, Horwitz D, Levy B. Results of the knee. J Bone Joint Surg Am.2007;89:614-20.

Cole PA, Zlowodzki M, Kreger PJ. Treatment of proximal tibia fractures using the less invasive stabilization system: surgical experience and early clinical results in 77 fractures. J Orthop Trauma 2004; 18: 528-535.

Mathur H, Acharya S, Nijhawan VK, Mandal SP , Opearivetibialfractures:Internal or external fixation. Indian J Orthop 2011;45(2):116-124.

Jain D, Selhi HS, Mahindra P, Kohli S, Yamin M, Results of proximal tibial fractures managed with periarticular locking plate: A series of 34 cases. Indian J Res Rep Med Scei (IJRRMS) 2012;2(4):1-5.
Published
2015-12-31
How to Cite
1.
Maravi D.S., Ganvir A., Gaur S. Outcome analysis of tibial plateau fractures fixed by single lateral periarticular locking plate. ojmpc [Internet]. 2015Dec.31 [cited 2024Nov.23];21(2):64-9. Available from: https://ojmpc.com/index.php/ojmpc/article/view/15
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