scholarly journals Small Wire External Fixation for High-Energy Tibial Plateau Fractures

2007 ◽  
Vol 15 (2) ◽  
pp. 137-143 ◽  
Author(s):  
H Kataria ◽  
N Sharma ◽  
RK Kanojia
Keyword(s):  
Soft Tissue ◽  
External Fixation ◽  
Tibial Plateau ◽  
High Energy ◽  
Tibial Plateau Fractures ◽  
High Rate ◽  
Anatomical Reconstruction ◽  
Functional Score ◽  
Soft Tissue Necrosis ◽  
The Mean

Purpose. To assess results of small wire external fixation using a ligamentotaxis technique for high-energy tibial plateau fractures. Methods. Between April 2002 and May 2004, 38 consecutive patients aged 21 to 60 (mean, 32) years underwent small wire external fixation for high-energy tibial plateau fractures. 15 involved the right and 23 the left knee. 34 were closed and 4 were open injuries. Fractures were classified according to Schatzker's staging system. After a minimal of 2 years' follow-up (range, 24–42 months), each affected knee was evaluated using Rasmussen's (1) 30-point clinical grading system and (2) radiological evaluation. Results. There were 22 type-VI and 16 type-V Schatzker tibial plateau fractures. Complications consisted of: 2 superficial infections, 3 pin site infections, and 4 peroneal nerve palsies. No soft tissue necrosis or devitalisation occurred. The mean range of knee movement was 132°. The mean Rasmussen radiological score was 14 (range, 10–18): excellent in 6, good in 26, and fair in 6. The mean Rasmusssen functional score was 26 (range, 17–30): excellent in 19 patients, good in 17, and fair in 2. Clinical results did not parallel the radiological results. Conclusion. Small wire external fixation allows anatomical reconstruction of the articular surface, stable fixation of fracture fragments, early movement of the joint, and care of associated soft tissue injuries, without a high rate of complications.

MANAGEMENT OF HIGH VELOCITY TIBIAL PLATEAU FRACTURES BY LIGAMENTOTAXIS USING ILIZAROV EXTERNAL FIXATOR

2021 ◽  
pp. 33-35
Author(s):  
Mayank Poddar ◽  
Abhinav Sinha ◽  
Amit Narang
Keyword(s):  
Soft Tissue ◽  
High Velocity ◽  
Bone Grafting ◽  
Tibial Plateau ◽  
High Energy ◽  
Tibial Plateau Fractures ◽  
Type Iv ◽  
Schatzker Type ◽  
Duration Of Surgery ◽  
The Mean

Background: Tibial plateau fractures resulting from high energy trauma, typically Schatzker type IV, V and VI pattern fractures are difcult to deal with due to poor overlying soft tissue cover. Ligamentotaxis with ilizarov ring xator can be a suitable denitive treatment option for such injuries with fewer associated complications as compared to internal xation. Patients and Methods: 30 patients within the age group of 18-80 years with Schatzker type IV, V and VI pattern injuries were included in the study. A four ring ilizarov assembly was used with knee spanning with a proximal femoral ring. The patients were followed for 12 months and evaluation was analyzed as per Rasmussen clinical and radiological criteria. Results: The mean age of patients in our study was 39.76 years. Twenty cases were Schatzker type VI, 7 cases were Schatzker type IV (with extensive soft tissue swelling following high velocity trauma) and only 3 cases were type V. The mean duration of surgery was 47±12 mins without bone grafting and 72±14 mins with bone grafting. The mean interval from injury to surgery was 2.36 days (range 1-5 days). Rasmussen total anatomical outcome was excellent in 14 patients(46.66%) and good in 16 patients(53.33%). Rasmussen total functional outcome was excellent in 21 patients(70%) and good in 9 patients(30%). Final Outcome was excellent in 22 patients(73.33%) and good in 8 patient(26.66%). Discussion: High velocity tibial plateau fractures, when treated with internal xation and plating, carry a higher risk of associated complications ranging from deep infections to even compartment syndrome. The rate of re-operation following internal xation in such injuries has been high with most of the re-surgeries being required within one year of primary xation which adds to the morbidity of the patient. Ligamentotaxis with ilizarov ring xation as denitive treatment in such cases can be a fruitful operation with lesser complications and early return to previous level of activity.

scholarly journals High-energy tibial plateau fractures treated with Ilizarov fixator

2019 ◽  
Vol 147 (7-8) ◽  
pp. 427-431
Author(s):  
Slavko Tomic ◽  
Andreja Baljozovic ◽  
Danilo Jeremic
Keyword(s):  
Soft Tissue ◽  
Knee Society Score ◽  
Tibial Plateau ◽  
Articular Surface ◽  
High Energy ◽  
Tibial Plateau Fractures ◽  
Anatomical Reconstruction ◽  
Significant Group ◽  
Ilizarov Fixator

Introduction/Objective. Tibial plateau fractures constitute a significant group of injuries to a major weight-bearing joint. High-energy fractures are difficult to treat, as they entail articular depression, condylar displacement, dissociation of comminuted metaphysis, and closed degloving injuries. The principles of the treatment are anatomical reconstruction of the articular surface, restoration of the anatomical axis, fixation spanning the metaphyseal comminution, and further minimization of soft tissue injury. The aim of this study is to evaluate the clinical outcome of using Ilizarov external fixator in the treatment of high-energy Schatzker IV, V, and VI tibial plateau fractures. Methods. This retrospective study was conducted from 2013?2016 on 35 patients (36 fractures) with high-energy tibial plateau fractures classified as Schatzker type IV, V, and VI. The mechanisms of injury were road traffic accident, fall from a height and direct trauma. The fractures were closed in 26 cases and open in 10 cases. All patients were treated with ligamentotaxis and percutaneous fixation using Ilizarov fixator. Functional outcome was determined using the Knee Society Score. Results. The mean follow-up period was 20 months. All fractures healed in an average time of 14 weeks. The range of knee flexion after one-year follow-up averaged at 100?. Average Knee Society Score in our study was 77. Conclusion. Ilizarov external fixation is a safe and efficient treatment modality for high-energy tibial plateau fractures. It allows reconstruction of the articular surface, stable fixation, early rehabilitation, and care of soft tissue injuries.

scholarly journals The staged treatment for tibial plateau fractures and the reconstruction of lateral column with autogenous iliac bone: an efficacy analysis report

2021 ◽  
Author(s):  
Dong Li ◽  
Xiao Liang ◽  
Kun Xi ◽  
Bin Zhao ◽  
Fushan Hou
Keyword(s):  
Soft Tissue ◽  
Tissue Damage ◽  
Tibial Plateau ◽  
Tibial Plateau Fractures ◽  
Iliac Bone ◽  
Soft Tissue Damage ◽  
Bony Union ◽  
Lateral Column ◽  
Soft Tissue Necrosis ◽  
Staged Treatment

Abstract Background: Complications in treating comminuted tibial plateau fractures with extensive soft tissue damage are common. In this study, we discussed the effect of staged treatment in the reconstruction of the lateral column with autogenous iliac bone using case follow-up. Methods: A retrospective analysis of 18 patients with comminuted tibial plateau fractures and extensive soft tissue damage from October 2016 to February 2020 who underwent staged treatment in our hospital. After the soft tissue damage repair, a large autologous iliac bone was used to reconstruct the lateral column of the tibial plateau.Results: All 18 patients were followed up over the course of 8-40 months, with an average of 23.44 months. All patients reported zero postoperative infection, skin and soft tissue necrosis, and loosening/breakage of the internal fixation. Regular postoperative review revealed that all patients achieved complete bony union, as evidenced by X-ray film, at 6 months after operation. Knee function (HSS) scores averaged 86.72 points at 1 year after operation; 15 people with 85 points or more, 2 people with 70-84 points, and one with 68 points. The excellent rate, according to HSS was 90%.Conclusions: Complex tibial plateau fractures with extensive soft tissue damage can be effectively remedied with a staged treatment, wherein a lateral column reconstruction is performed using a large iliac bone.

scholarly journals High energy tibial plateau fractures treated with hybrid external fixation

2011 ◽  
Vol 6 (1) ◽  
pp. 35 ◽  
Author(s):  
George C Babis ◽  
Dimitrios S Evangelopoulos ◽  
Panagiotis Kontovazenitis ◽  
Konstantinos Nikolopoulos ◽  
Panagiotis N Soucacos
Keyword(s):  
External Fixation ◽  
Tibial Plateau ◽  
High Energy ◽  
Tibial Plateau Fractures ◽  
Hybrid External Fixation

Infection After Spanning External Fixation for High-Energy Tibial Plateau Fractures: Is Pin Site–Plate Overlap a Problem?

2012 ◽  
Vol 26 (2) ◽  
pp. 92-97 ◽  
Author(s):  
Catherine Laible ◽  
Emily Earl-Royal ◽  
Roy Davidovitch ◽  
Mike Walsh ◽  
Kenneth A Egol
Keyword(s):  
External Fixation ◽  
Tibial Plateau ◽  
High Energy ◽  
Tibial Plateau Fractures ◽  
Pin Site

scholarly journals Treatment of high energy tibial plateau fractures with hybrid external fixator: intermediate term outcome

2017 ◽  
Vol 5 (10) ◽  
pp. 4582
Author(s):  
Alamgir Jahan ◽  
Muhammad Haseeb ◽  
Fahad Wazir
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
External Fixator ◽  
Tibial Plateau ◽  
High Energy ◽  
Deep Infection ◽  
Tibial Plateau Fractures ◽  
Open Fractures ◽  
Hybrid External Fixator ◽  
Primary Management

Background: High energy tibial plateau fractures pose a management challenge because of the complexity of bone and soft tissue trauma. Because of the frequency and magnitude of soft tissue of soft tissue injury in these fractures, early internal fixation becomes difficult. Wound breakdown and deep infection are common complications in plating of these difficult fractures. Primary management with hybrid external fixator can be a useful alternative to internal fixation in such cases.Methods: The study was a prospective case series done in the orhtopaedic department of a teaching hospital. 20 patients were studied. There were 13 Schatzker VI, 5 Schatzker V and 2 Schatzker IV fractures included. 4 patients had open fractures and 1 had compartment syndrome. Open fractures were operated in emergency department. Those with severe swelling and blisters were allowed few days to settle. Primary fixation using a hybrid external fixator was done. Mobilisation was started early. Patients were followed up to 1 year.Results: Union was obtained in all patients within 18 weeks. There was only deep infection. 95% patients had range of motion of 90 degrees or more. No patient had an extensor lag.Conclusions: Primary management of high energy tibial plateau fractures using hybrid external fixator is a reasonable option for cases that are not immediately amenable to internal fixation. It provides adequate stabilization to allow early motion and hastens patient rehabilitation. We have a good experience with this technique and recommend it for judicious use.

scholarly journals Functional outcome of hybrid external fixator in proximal tibial fractures Schatzker type V and VI with Gustillo grade-II

2021 ◽  
Vol 8 (1) ◽  
pp. 43
Author(s):  
Johney Juneja ◽  
Mohzin Asiger ◽  
Dinesh Kumar ◽  
Mahendra P. Jain ◽  
Gaurav Garg ◽  
...  
Keyword(s):  
Soft Tissue ◽  
External Fixator ◽  
Tibial Plateau ◽  
High Energy ◽  
Tibial Plateau Fractures ◽  
Bony Union ◽  
Fracture Stabilization ◽  
Hybrid External Fixator ◽  
Schatzker Type ◽  
Type V

<h2>Background: Management of high energy tibial plateau fractures along with extensive soft tissue damage is still challenging to many orthopaedic surgeons. This study evaluates the purpose of hybrid external fixator intreating high energy tibial plateau fractures with minimal invasion and accurate reduction.</h2><h2>Methods: Twenty patients with high energy Schatzker type V and VI tibial plateau fractures with severe soft tissue injury were enrolled into the study in RNT medical college, Udaipur.</h2><h2>Results: The results- bony union, range of movements and associated complications were assessed. All fractures united in an average time period of 20 weeks. Ten patients developed knee stiffness, five patients developed delayed union andthreenon-union.15 patients required split skin graft. Final outcome showed excellent score in 53 patients.</h2><h2>Conclusions: Hybrid external fixation is a safe option for managing complex high energy tibial plateau fractures by simultaneously providing adequate fracture stabilization and necessary protection to soft tissue healing to achieve bony union.</h2>

External fixation characteristics drive cost of care for high-energy tibial plateau fractures

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Patrick Albright ◽  
Arthur Only ◽  
Harsh R Parikh ◽  
Dylan L. McCreary ◽  
Kevin Hayek ◽  
...  
Keyword(s):  
External Fixation ◽  
Tibial Plateau ◽  
High Energy ◽  
Cost Of Care ◽  
Tibial Plateau Fractures
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