New Approaches to Systematization and Treatment of Impression Monocondylar Tibial Plateau Fractures

Treatment results for 109 patients (mean age 56 ± 1.7 years) with monocondylar impression tibial plateau fractures (ITPF) are presented. Patients from the control group (n=63) were operated on during the period from 2008 to 1010, patients from the main group (n=46) - from 2011 to 2013. Patients from the main group were treated with regard for injury localization relative to plateau center according to proposed operational classification of impression fractures (by CT data) and algorithm to choose the osteosynthesis technique depending on the anatomic and morphologic peculiarities of the intra-articular injury. In patients from the main group the evaluation by Rasmussen scale 36 months after intervention showed excellent results in 15 (38.4%), good - in 22 (56.4%), satisfactory - in 5 (12.8%) of patients, no poor results were recorded, and in patients from the control group - in 6 (11.5%), 8 (15.3%), 36 (69.3%) and 3 (5,8%) patients, respectively. Three (7.6%) complications (secondary displacement of fragments (2), knee contracture (1)) were observed in the main group, and 11 (20.9%) in the control group (20.9%) - local infectious inflammatory process (4), secondary displacement of plateau fragments (6), condylar sag (1). Perfected tactics of treatment of patients with ITPF enabled to achieve 3.48 times more excellent and good results (p<0.05).

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The Chertsey classification of tibial plateau fractures and a comparison of the outcome of treatment with internal fixation or an Ilizarov fine wire circular frame

Injury Extra ◽

10.1016/j.injury.2010.07.435 ◽

2010 ◽

Vol 41 (12) ◽

pp. 140 ◽

Cited By ~ 1

Author(s):

E. Guryel ◽

S. Maret ◽

R. Sharma ◽

K. Newman ◽

D. Elliott ◽

...

Keyword(s):

Internal Fixation ◽

Tibial Plateau ◽

Tibial Plateau Fractures ◽

Fine Wire ◽

Circular Frame

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Letter to the Editor concerning “Revisiting the Schatzker classification of tibial plateau fractures” by Kfuri M, Schatzker J. Injury. 2018 Dec;49(12):2252–2263

Injury ◽

10.1016/j.injury.2019.01.020 ◽

2019 ◽

Vol 50 (3) ◽

pp. 820-821

Author(s):

Arvind Kumar ◽

Aditya Jain ◽

Samarth Mittal ◽

Naveed Aga

Keyword(s):

Tibial Plateau ◽

Tibial Plateau Fractures ◽

Letter To The Editor ◽

Schatzker Classification

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Two column classification of tibial plateau fractures; description, clinical application and reliability

Injury ◽

10.1016/j.injury.2019.04.021 ◽

2019 ◽

Vol 50 (6) ◽

pp. 1247-1255 ◽

Cited By ~ 1

Author(s):

Adeel Anwar ◽

Yufang Zhang ◽

Zhi Zhao ◽

Yanming Gao ◽

Lin Sha ◽

...

Keyword(s):

Clinical Application ◽

Tibial Plateau ◽

Tibial Plateau Fractures

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Schatzker Classification of Tibial Plateau Fractures: Use of CT and MR Imaging Improves Assessment

Radiographics ◽

10.1148/rg.292085078 ◽

2009 ◽

Vol 29 (2) ◽

pp. 585-597 ◽

Cited By ~ 84

Author(s):

B. Keegan Markhardt ◽

Jonathan M. Gross ◽

Johnny Monu

Keyword(s):

Mr Imaging ◽

Tibial Plateau ◽

Tibial Plateau Fractures ◽

Schatzker Classification

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Inter- and Intra-Observer Variation of the Schatzker and AO/OTA Classifications of Tibial Plateau Fractures and a Proposal of a New Classification System

Annals of The Royal College of Surgeons of England ◽

10.1308/003588407x187667 ◽

2007 ◽

Vol 89 (4) ◽

pp. 400-404 ◽

Cited By ~ 39

Author(s):

CP Charalambous ◽

M Tryfonidis ◽

F Alvi ◽

M Moran ◽

C Fang ◽

...

Keyword(s):

Classification System ◽

Tibial Plateau ◽

Observer Variation ◽

Tibial Plateau Fractures ◽

New Classification ◽

Plain Radiographs

INTRODUCTION The aim of this study was to evaluate the intra- and inter-observer variation of the Schatzker and AO/OTA classifications in assessing tibial plateau fractures, using plain radiographs. PATIENTS AND METHODS Fifty tibial plateau fractures were classified independently by six observers as per the Schatzker and AO/OTA classifications, using antero-posterior and lateral plain radiographs. Assessment was done on two occasions, 8 weeks apart. RESULTS We found that both the Schatzker and AO/OTA classifications have a high intra-observer (κ = 0.57 and 0.53, respectively), and inter-observer (κ = 0.41 and 0.43, respectively) variation. Classification of tibial plateau fractures into unicondylar versus bicondylar and pure splits versus articular depression ± split conferred improved inter- and intra-observer variation. CONCLUSIONS The high inter-observer variation found for the Schatzker and AO/OTA classifications must be taken into consideration when these are used as a guidance of treatment and when used in evaluating patients' outcome. Simply classifying tibial plateau fractures into unicondylar versus bicondylar and pure splits versus articular depression ± split may be more reliable.

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PERIOPERATIVE ANESTHESIA: TO DO OR NOT TO DO?

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.32414/0869-8678-2018-2-36-40 ◽

2018 ◽

Vol 25 (2) ◽

pp. 36-40

Author(s):

S. A. Firsov ◽

A. S. Lepilov ◽

R. P. Matveev ◽

V. S. Savinkin

Keyword(s):

Hip Arthroplasty ◽

Motor System ◽

Main Group ◽

Narcotic Analgesic ◽

Control Group ◽

Control Groups ◽

Treatment Results ◽

Analog Scale ◽

And Control

Introduction. In patients with chronic loco-motor system diseases the pain often persists after arthroplasty and does not respond to symptomatic therapy.Purpose of study: to evaluate the efficacy of perioperative use of Meloxicam in patients after hip arthroplasty. Patients and methods. The follow-up covered 120 patients (mean age 64.4±5.23 years) after hip arthroplasty. In the main group (n=60) Meloxicam was given 7 days prior to and 3 weeks after surgery; after intervention narcotic analgesic was used on the request. In control group (n=60) the patients were only on narcotic analgesic on request after operation. Treatment results were assessed by 100-millimeter visual analog scale (VAS) and D’Aubigné-Postel Score.Results. Seven days before the surgery the pain severity in the main and control groups was comparable: 85±2.3 and 84±2.1, respectively. In 2 days after operation the pain relief was more pronounced in the main group — 69±2.1 mm versus 82±3.4 mm in the control group (p0.05). In 3 months those indices made up 10±2.1 and 35±12.6 mm (p0.001), respectively. In the main group the result was assessed as the excellent and good in 22 patients, in the rest of patients as satisfactory by d’Aubigné-Postel Score. In the control group the good result was recorded in 9, satisfactory — in 47 and poor — in 4 cases.Conclusion. Meloxicam may be considered as an effective perioperative analgesic in large joints arthroplasty.

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Standard open operative interventions in surgical treatment of patients, suffering an acute complicated pancreatitis

Klinicheskaia khirurgiia ◽

10.26779/2522-1396.2018.07.27 ◽

2018 ◽

Vol 85 (7) ◽

pp. 27-29

Author(s):

V. P. Аndriushchenko ◽

D. V. Аndriushchenko ◽

Yu. S. Lysiuk

Keyword(s):

Surgical Treatment ◽

Comparison Group ◽

Surgical Intervention ◽

Main Group ◽

Control Group ◽

Treatment Results ◽

Surgical Interventions ◽

Second Stage ◽

Standard Operations

Objective. To determine the character and optimal volume of standard open surgical interventions in an acute complicated pancreatitis (ACP) with elaboration of the main technical elements of the operations. Маterials and methods. There were operated 96 patients, suffering ACP. The main group consisted of 47 patients, in whom open interventions were performed primarily in 19, and as the second-stage procedure after application of miniinvasive interventional technologies (МIТ) – in 28. The comparison group consisted of 49 patients, in whom standard operations were done only. Results. Application of MIТ have promoted the indications narrowing for performance of primary open operations more than twice. In the main group the arcuate-like subcostal access was applied predominantly - in 26 (55%) observations (χ²=14.287; р=002), while in a control one – a median upper laparotomy – in 37 (76%) observations (χ²=38.43, р < 0.001). The method of closed draining in accordance to procedure of Beger was used predominantly in the main group of patients – in 43% of observations, comparing with a control group - 9% of observations (χ²=12.965; р=0.003). In 23% patients of the main group and in 26% patients of a control one (χ²=0.0013; р=0.05), when the extended purulent-necrotic inflammation process have presented, a staged sanation was applied, using programmed relaparotomies. Some technical elements of the surgical intervention were improved. Conclusion. Application of standard open operations in accordance to elaborated principle is accompanied by improvement of the treatment results in patients, suffering ACP.

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