The Knee: Tibial Plateau Fracture Reduction Techniques Utilizing Cannulated Screw Fixation

Objective:Â Â To determine percutaneous screw fixation (PSF) as fair treatment option for Schatzker type I, closed tibial plateau fracture in adults.Patients and Methods:Â Â 30 male and female adults between the ages of 20 and 40 were included. Only displaced Schatzkar type I closed tibial plateau fractures without any associated injury or complication were included. Type II, III, IV, V and VI, fractures with infection, patients with other severe injuries and neurovascular compromise fractures were excluded. Patients were followed weekly for one month, every alternate week for four months, thereafter monthly for up to six months to assess range of motion, deformity, union or any other complication.Results:Â Â Mean healing was 11.6 weeks. Mean hospital stay was 8.4 days. The overall clinical results were excellent in 20 (66.6%), good in 8 (26.6%), fair in 2 (6.6%) cases.Conclusion:Â Â Percutaneous screw fixation providedbetter results in close displaced type I Schatzker tibial plateau fracture in adults. It is minimally invasive and achieved articular anatomical reduction, rigid fixation and early mobilization.

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The outcome after lateral tibial plateau fracture treated with percutaneus screw fixation show a tendency towards worse functional outcome compared with a reference population

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-015-0497-9 ◽

2015 ◽

Vol 42 (2) ◽

pp. 177-184 ◽

Cited By ~ 6

Author(s):

R. Elsoe ◽

P. Larsen ◽

N. Shekhrajka ◽

L. Ferreira ◽

S. E. Ostgaard ◽

...

Keyword(s):

Functional Outcome ◽

Tibial Plateau ◽

Tibial Plateau Fracture ◽

Screw Fixation ◽

Reference Population ◽

Lateral Tibial Plateau ◽

Plateau Fracture

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Does Time to Theatre Affect the Ability to Achieve Fracture Reduction in Tibial Plateau Fractures?

Journal of Clinical Medicine ◽

10.3390/jcm11010138 ◽

2021 ◽

Vol 11 (1) ◽

pp. 138

Author(s):

David Stuart Kitchen ◽

Jack Richards ◽

Peter J. Smitham ◽

Gerald J. Atkins ◽

Lucian B. Solomon

Keyword(s):

Knee Injury ◽

Tibial Plateau ◽

Tibial Plateau Fracture ◽

Soft Tissue Injuries ◽

Fracture Reduction ◽

Post Injury ◽

Outcome Scores ◽

Plateau Fracture ◽

Surgical Fixation ◽

One Year

Surgical management of displaced tibial plateau fracture (TPF) is often delayed due to accompanying soft tissue injuries sustained at the time of injury. The primary aim of this study was to assess the effect of time to surgery on fracture reduction in cases of TPF. The secondary aim was to assess the effect of preoperative demographics and residual articular step on Lysholm Scores and Knee Injury and Osteoarthritis Outcome Scores (KOOS) following fixation. Patients between 2006 and 2017, managed by a single surgeon, were prospectively enrolled in the study. Reduction of articular step, defined as <2 mm, was assessed by a single blinded examiner. A total of 117 patients were enrolled, 52 with Schatzker II, 4 with Schatzker IV, and 61 with Schatzker VI fractures. Patients were followed up to a mean of 3.9 years. Analysis showed that the ability to achieve fracture reduction was negatively influenced by time to theatre, with the odds of achieving reduction decreasing 17% with each subsequent day post injury (p = 0.002). Furthermore, an increased time to theatre was associated with a reduced Lysholm score at one year (p = 0.01). The ability to achieve fracture reduction did not influence PROMs within the study period. We conclude that delay in surgical fixation negatively affects fracture reduction in TPF and may delay recovery. However, residual articular step does not necessarily influence PROMs over the mid-term.

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