scholarly journals First clinical results after lateral epicodyle osteotomy and meniscus subluxation in the repair of tibial plateau fractures

2020 ◽  
Vol 8 (9_suppl7) ◽  
pp. 2325967120S0052
Author(s):  
Alexander Korthaus ◽  
Tobias Malte Ballhause ◽  
Jan-Philipp Kolb ◽  
Matthias Krause ◽  
Karl-Heinz Frosch ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Case Series ◽  
Clinical Score ◽  
Clinical Results ◽  
Tibial Plateau Fractures ◽  
Lateral Tibial Plateau ◽  
Lateral Epicondyle ◽  
Radiological Results ◽  
Early Results ◽  
Clinical And Radiological Results

Introduction: Recently, a novel extended approach for comminuted lateral tibial plateau fractures was introduced. It includes a lateral epicondyle osteotomy and meniscus subluxation allowing for an almost complete overview of the lateral tibial plateau. First clinical results are presented. Hypotheses: We hypothesized, that a superior visualization using the novel approach in demanding cases leads to improved radiologic and clinical outcomes. Methods: A consecutive case series of ten in which the approach was used was followed prospectively. The cases were classified using the “10-segment classification” and the “AO classification”. To evaluate the clinical and radiological results, the Rasmussen score was applied. Results: Excellent to good clinical and radiological results were encountered after a median follow-up of 8,6 (IQR 4,3) months. The clinical score amounted to a median of 25 (IQR 2,8) and the radiological score a median of 17 (IQR 2,0). Conclusion: The early results after the treatment of demanding cased with a high degree of joint comminution presented are promising with excellent to good results, only. At the same time, despite an extended surgical procedure, no complications were encountered in the cohort. As suggested by the authors before, tibial plateau fractures should be managed using a stepwise approach with extension of the approach as individually required.

scholarly journals Prediction of Meniscal and Ligamentous Injuries in Lateral Tibial Plateau Fractures Based on Measurements of Lateral Plateau Widening on Multidetector Computed Tomography Scans

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Jan P. Kolb ◽  
Marc Regier ◽  
Eik Vettorazzi ◽  
Norbert Stiel ◽  
Jan P. Petersen ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Tibial Plateau ◽  
Multidetector Ct ◽  
Lateral Meniscus ◽  
Case Series ◽  
Lateral Collateral Ligament ◽  
Tibial Plateau Fractures ◽  
Lateral Tibial Plateau ◽  
Plain Radiographs ◽  
Lateral Plateau

Background. The influence of increasing lateral plateau widening on the frequency of meniscal and ligamentous lesions in lateral tibial plateau fractures has been examined in very few studies using plain radiographs. Because the amount of this parameter cannot be measured accurately on plain radiographs, the purpose of this survey was to look for a possible correlation between the extent of lateral plateau widening, as measured on multidetector CT (MDCT) scans, and different soft-tissue injuries determined from magnetic resonance imaging (MRI). Materials and Methods. 55 patients with a lateral tibial plateau fracture were included in this retrospective case series. Patient age averaged 52.6 years (SD = 18.0). The degree of lateral plateau widening was measured on CT images. MRIs were screened for meniscal and ligamentous injuries. Results. We found a significant effect of increasing lateral plateau widening on the incidence of lateral meniscus lesions (P = 0.021), lateral collateral ligament tears (P = 0.047), and the overall quantity of meniscal and ligamentous lesions (P = 0.001). Discussion. MRIs are not widely used as a diagnostic tool in lateral plateau fractures of the tibia. Reasons might be the costs and the fact that it is a time-consuming examination. The results of this study may help to estimate the probability of specific soft-tissue lesions in lateral tibial plateau fractures based on measurements of lateral plateau widening on MDCT scans, and they may guide the decision for additional MRI and/or arthroscopically assisted repair.

scholarly journals Early Results of the Medial Approach for Arthroscopic-Assisted Fixation of Lateral Tibial Plateau Fractures

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0004
Author(s):  
Tunay Erden ◽  
Suat Batar ◽  
Gökçer Uzer ◽  
Demet Pepele Kurdal ◽  
Nurzat Elmalı
Keyword(s):  
Tibial Plateau ◽  
Soft Tissues ◽  
Lateral Meniscus ◽  
Case Series ◽  
Tibial Plateau Fractures ◽  
Meniscus Tear ◽  
Type I ◽  
Lateral Tibial Plateau ◽  
Schatzker Type ◽  
Diagnostic Arthroscopy

The use of arthroscopy in the management of tibial plateau fractures is not a particularly new concept. It has been used successfully for Schatzker types I–III fractures. In addition to evaluating the fracture itself, it is easier to evaluate the other intraarticular structures. Coventionally, reduction for lateral tibial plateau fractures have been performed through a laterally based metaphyseal window, which is not without limitations, including difficulty with reduction of the fracture, as well as bone grafting though the resultant short subchondral tunnel. Also, there is a risk of lateral vascular supply distrubtion because of same side fracture. A medially based metaphyseal window to approach lateral tibial plateau fractures allows for minimal insult to the soft tissues, with advantageous ease of reduction and grafting through a longer tunnel for subchondral support. We aimed to present our initial experiences in twelwe cases approaching lateral tibial plateau fractures through a medial metaphyseal window. Material-Methods: Our series involves 12 patients with 7 Schatzker type II, 3 Schatzker type I, and 2 Schatzker type III fractures. There were 8 males and 4 females. The average age at the time of surgery was 37 (25-57) years. All of the patients underwent plain radiography and BT in each knee Time from injury to surgery was 6.2 days. Follow up was 18 months (9-22 months).Firstly diagnostic arthroscopy was performed. Concomittant pathology was adreessed as needed. There was 3 lateral meniscus tear that treated with partial meniscectomy. An ACL guide pin was placed percutaneously anteromedial tibia approximately 9 cm distal to the joint line. Once stisfactory positioning a cortical window 1x2 cm. made around the guide pin. Reduction was accomplished with a bone tamp that fits easily into the tunnel. Screws were used as rafters to support the articular surface and subchondral bone. We used in 7 patients lateral plate and screws and in 5 patients only screws. Care was taken to keep pump pressure at approximately 40 millimeters of mercury for alleviate the risk of compartment syndrome. Results: No complications related to the procedure were observed. No secondary loss of reduction was observed in radiological controls. Functional assessment according to HSS of the patients were excellent in 5 cases, good in 5 cases and fair 2 cases. Discussion: Because depressed fragments are elevated from distal cortical windows, the importance of an intact, or easily restored, “cortical envelope” is paramount. This case series showed satisfactory early clinical results. [Figure: see text][Figure: see text]

Impaction bone grafting has potential as an adjunct to the surgical stabilisation of osteoporotic tibial plateau fractures: Early results of a case series

Injury ◽  
2015 ◽  
Vol 46 (6) ◽  
pp. 1089-1096 ◽  
Author(s):  
Gerrit J. van de Pol ◽  
Lukas D. Iselin ◽  
Stuart A. Callary ◽  
Dominic Thewlis ◽  
Claire F. Jones ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Tibial Plateau ◽  
Case Series ◽  
Tibial Plateau Fractures ◽  
Impaction Bone Grafting ◽  
Early Results

Split-Depressed Lateral Tibial Plateau Fractures

2018 ◽  
Vol 32 (7) ◽  
pp. e270-e275 ◽  
Author(s):  
Richard J. Bowles ◽  
Vivek Chadayammuri ◽  
Todd Baldini ◽  
Antonio Brecevich ◽  
Cyril Mauffrey
Keyword(s):  
Tibial Plateau ◽  
Tibial Plateau Fractures ◽  
Lateral Tibial Plateau

Extended Anterolateral Approach for Complex Lateral Tibial Plateau Fractures

2017 ◽  
Vol 30 (03) ◽  
pp. 204-211 ◽  
Author(s):  
Joseph Schatzker ◽  
Marcello Castiglia ◽  
Vincenzo Giordano ◽  
Fabricio Fogagnolo ◽  
James Stannard ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Tibial Plateau Fractures ◽  
Anterolateral Approach ◽  
Lateral Tibial Plateau

Function and Knee Range of Motion Plateau Six Months following Lateral Tibial Plateau Fractures

2019 ◽  
Vol 33 (05) ◽  
pp. 481-485 ◽  
Author(s):  
Anthony V. Christiano ◽  
Christian A. Pean ◽  
David N. Kugelman ◽  
Sanjit R. Konda ◽  
Kenneth A. Egol
Keyword(s):  
Range Of Motion ◽  
Tibial Plateau ◽  
Tibial Plateau Fractures ◽  
Lateral Tibial Plateau ◽  
Post Hoc Analysis ◽  
Time Points ◽  
Significant Difference ◽  
Friedman's Test ◽  
Post Hoc ◽  
Bicondylar Tibial Plateau

AbstractThe purpose of this study is to determine when functional outcome no longer improves following tibial plateau fracture. A patient series of operatively treated tibial plateau fractures was reviewed. Patients were evaluated using the short musculoskeletal function assessment (SMFA), range of motion (ROM) assessment, and pain levels at visual analog scale (VAS) at 3, 6, and 12 months postoperatively. Fractures were classified by the Schatzker's classification using preoperative imaging. The case series was divided into two groups based on fracture patterns. Friedman's tests were conducted to determine if there were differences in SMFA, ROM, or VAS throughout the postoperative course. A total of 117 patients with tibial plateau fractures treated operatively, with complete follow-up and without complication, were identified. Seventy-seven patients (65.8%) sustained lateral tibial plateau fractures (Schatzker's I–III). Friedman's test demonstrated significant differences in SMFA (p < 0.0005) and ROM (p < 0.0005) at the three time points. Post hoc analysis demonstrated a significant difference in SMFA (p < 0.0005) and ROM (p = 0.003) between 3 and 6 months postoperatively but no significant difference in either metric between 6 and 12 months postoperatively. Friedman's test demonstrated no significant difference in VAS postoperatively (p = 0.210). Forty patients (34.2%) sustained medial or bicondylar tibial plateau fractures (Schatzker's IV–VI). Friedman's test demonstrated significant differences in SMFA (p < 0.0005) and ROM (p < 0.0005) at the three time points. Post hoc analysis demonstrated a strong trend toward significance in SMFA between 3 and 6 months postoperatively (p = 0.088), and demonstrated a significant difference between 6 and 12 months postoperatively (p = 0.013). ROM was found to be significantly different between 3 and 6 months postoperatively (p = 0.010), but no difference was found between 6 and 12 months postoperatively (p = 0.929). Friedman's test demonstrated no significant difference in VAS postoperatively (p = 0.941). In this cohort, no significant difference in function, ROM, or pain level exists between 6 and 12 months after treatment of lateral tibial plateau fractures. However, there are significant improvements in function for at least 1 year following medial or bicondylar tibial plateau fractures.

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