Long-term outcomes of surgical treatment of patients with tibial plateau fractures repaired with Ilizarov external fixation

Introduction Fractures of the tibial plateau are classified by the location of the fracture line, associated capsular ligamentous injuries to the knee and can result from different types of high – or low-energy mechanisms of injury in patients of any age with different bone quality. These factors are responsible for different long-term functional outcomes and the lack of a generally accepted algorithm for diagnosis and treatment. The objective of the study was to analyze the long-term functional outcomes in patients with tibial plateau fractures treated with the Ilizarov external fixation. Material and methods The review included long-term outcomes of 59 patients with tibial plateau fractures treated with the Ilizarov external fixator. Long-term results were evaluated in 53 patients out of 59 (89.83 %) using a subjective and objective clinical assessment system.The follow-up period ranged from 2 to 4 years. Patients were requested to complete the Oxford Knee Score questionnaire used in subjective outcome. Results Knee joint function of patients with tibial plateau fractures treated with the Ilizarov external fixation were rated as satisfactory (n = 34; 64.15 %); 16 (30.19 %) and 3 (5.66 %) patients were diagnosed with mild and moderate gonarthrosis, respectively. No infection that would affect the outcome was recorded in the study group. The mean Oxford Knee Score was 43.06 ± 3.44 (SD) in Schatzker type I split fractures of the lateral femoral condyle; 40.50 ± 5.57 (SD) in Schatzker type II split fractures combined with lateral articular surface depression; 40.71 ± 4.27 (SD) in Schatzker type III depression fractures; 42.33 ± 4.22 (SD) in Schatzker type IV medial condylar fractures; 38.50 ± 7.19 (SD) in Schatzker type V bicondylar fractures and 37.50 ± 5.17 (SD) in Schatzker type VI bicondylar fractures with dissociation of the metaphysis and diaphysis. Conclusions Tibial plateau fractures can be treated with the Ilizarov external fixation and also with the use of screws at any point of time that allows closed or open reduction of the fracture to ensure the early function of the operated limb, stable bone fixation, control of the fixation stiffness at any stage of treatment facilitating good and excellent functional outcomes.

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Posteromedial fragment fixation through Lobenhoffer approach in tibial plateau fractures

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20171891 ◽

2017 ◽

Vol 3 (3) ◽

pp. 497

Author(s):

Vijaysing S. Chandele ◽

Abhishek P. Bhalotia ◽

Milind V. Ingle ◽

Maroti R. Koichade

Keyword(s):

Functional Outcome ◽

Tibial Plateau ◽

Weight Bearing ◽

Oxford Knee Score ◽

Tibial Plateau Fractures ◽

Knee Score ◽

Early Weight Bearing ◽

Non Union ◽

Approach Time

Background: Management of tibial plateau fractures with coronal fractures especially posteromedial fragment is frequent and challenging. This study was conducted to evaluate the functional outcome of patients with tibial plateau fractures having posteromedial fragment treated with open reduction and internal fixation (ORIF) using Lobenhoffer approach.Methods: Thirty two patients with tibial plateau fractures having posteromedial fracture alone or part of bicondylar fracture was operated with ORIF using Lobenhoffer approach. Time to union, maintenance of alignment, rate of complications and functional outcome was assessed using Oxford knee score.Results: The mean time to healing was 16.4 weeks, without any complication in the form of non-union and infection. Malunion with secondary loss of alignment was seen in only one case due to fracture comminution and early weight bearing. Oxford knee score was good to excellent in all the cases. Conclusions: With recent development in understanding these fractures, ORIF gives excellent to good outcome in all patients operated through Lobenhoffer approach. Long term disability can be prevented by maintenance of adequate alignment and reduction through direct visualization of fracture.

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Patient-related outcomes of patellofemoral arthroplasty: experience of a single center

Arthroplasty ◽

10.1186/s42836-021-00074-8 ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

W. Y. M. Abeysekera ◽

W. Schenk

Keyword(s):

Oxford Knee Score ◽

Mixed Effects Models ◽

Knee Score ◽

Single Center ◽

Long Term Outcomes ◽

Patellofemoral Arthroplasty ◽

Linear Mixed Effects ◽

Significant Clinical Improvement ◽

One Year

Abstract Purpose The purpose of this prospective study was to present the experience of a single center on patellofemoral arthroplasty, in terms of patient-related outcomes. Method From January 2005 to January 2016, 42 patients with isolated patellofemoral osteoarthritis were treated. The patients were assessed using the Oxford Knee Score preoperatively, and one, five, and eight year(s) after surgery. The data of the patients were analyzed using linear mixed effects models. A P value of 0.05 was considered statistically significant. Results Among 42 patients who underwent patellofemoral arthroplasty, only 25 patients (31 limbs involved) had records up to 5 years. There was a significant clinical improvement of Oxford Knee Score postoperatively (P < 0.05), lowering the score on average by 10.4 ± 1.5 one year after surgery and 8.9 ± 1.9 five years after surgery. This improvement was independent of the types of implants (P > 0.05), gender (P > 0.05), age (P < 0.05), and body mass index (BMI) (P < 0.05). Conclusion Patellofemoral arthroplasty can significantly improve the knee function, and this improvement is independent of the type of implant, gender, age, and BMI. However, further studies will need to assess the long-term outcomes of PFA.

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The Mid-Term Radiological and Functional Outcomes of Bicondylar Tibial Plateau Fractures Managed with Open Reduction and Internal Fixation Using Dual Plates

Sultan Qaboos University Medical Journal [SQUMJ] ◽

10.18295/squmj.4.2021.059 ◽

2021 ◽

Author(s):

Angelo V. Vasiliadis ◽

Frideriki Poutoglidou ◽

Dimitrios Metaxiotis ◽

Anastasios Mpeletsiotis

Keyword(s):

Internal Fixation ◽

Functional Outcomes ◽

Open Reduction ◽

Tibial Plateau ◽

Tibial Plateau Fractures ◽

Radiological Outcome ◽

Schatzker Type ◽

Dual Plating ◽

Type V ◽

Bicondylar Tibial Plateau

Objective: This study was designed to evaluate the mid-term radiological and functional outcome of tibial plateau fractures treated by plating. Methods: Patients with Schatzker type V and type VI tibial plateau fractures who were managed with open reduction and internal fixation using dual plates were included in this retrospective study. The functional evaluation of the patients was carried out with the visual analogue scale (VAS), the health-related quality of life status was measured using the Short Form-36 (SF-36) and the dimensions of pain, stiffness and function were assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). For the radiological outcome evaluation, the modified Rasmussen criteria were used. Results: 57 patients (30 male and 27 female) were included in the study with a mean follow-up of 50.88 months. There were 23 Schatzker type V and 34 Schatzker type VI fractures. The majority of patients (86%) had a good to excellent radiological outcome. The mean VAS score was 1.65 for all the patients. The functional outcome was excellent in the majority of the patients. Among them, 5.3% (n = 3) suffered wound infection and all of the wounds healed after different treatments. All patients returned to their pre-injury activities of daily living and employment status, while 53% of the patients returned to sporting activities. Conclusion: Our findings support previous literature, which has demonstrated that bicondylar tibial plateau fractures can provide good to excellent radiological and functional outcomes if they were treated with open reduction and internal fixation with dual plating. Keywords: tibial plateau fracture; bicondylar fracture; Schatzker classification; dual plating

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Tibial plateau fractures in a limited-resource setting: A prospective study of surgical techniques and outcome over three years

American Journal of Orthopedic Research and Reviews ◽

10.28933/ajorr-2021-11-2807 ◽

2022 ◽

pp. 31

Author(s):

Keyword(s):

External Fixation ◽

Tibial Plateau ◽

Wide Spectrum ◽

Surgical Techniques ◽

Tibial Plateau Fractures ◽

Resource Setting ◽

Schatzker Type ◽

Satisfactory Outcome ◽

Pathologic Fractures ◽

Post Traumatic

Introduction: Tibial plateau fractures form a wide spectrum of injuries accounting for 1.2% of all fractures and a prevalence of 10 cases per 100,000 inhabitants. Methodology: A prospective consecutive multicentre study from May 2018 to May 2021 was carried out in Yaounde. All consenting cases of tibial plateau fracture underwent surgical treatment while patients with pathologic fractures, previous knee osteoarthritis, medically unfit for surgery, and discharging against medical advice were excluded. Data was analysed with SPSS 26.0 and the level of significance set at p<0.05. Results:Eighty-four (84) cases of tibial plateau fractures were sampled and 68 consented to surgery. The mean age was 42 ±13.6 years and sex ratio 2.4. Estimated prevalence was 2.2 cases per 100,000 inhabitants. Schatzker type II fractures were most represented (33.3%). The left leg was affected in 57.1%. Motorbike accidents were the main cause of injury (66.7%). Of the 68 operated, 63.3% by plating osteosynthesis, 32.4% by external fixation, and 4.4% by screws fixation. Tricortical iliac bone graft was realised in 4 cases. The minimum follow-up was 6 months, with a median of 18 months (5 to 37 months). Plating osteosynthesis (p<0.001), operative time between 60 to 120 minutes (p<0.02) and a good radiologic fracture healing (p<0.04) were associated with a satisfactory outcome. Poor prognosis was seen with open fractures (p<0.001), bridging external fixation (p<0.001), and Schatzker VI fractures (p<0.02). Complications included post-traumatic osteoarthritis (64.7%), post-traumatic osteomyelitis (29.4%), knee ankylosis (5.9%), and limb malalignment (30.9%). Conclusion:The prevalence of tibial plateau fractures remains lower than reported in literature but it is projected to rise. Plating remains a viable treatment option. A larger scale study will establish the burden of this entity in our context.

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Functional Evaluation in High Energy (Schatzker Type V and Type VI) Tibial Plateau Fractures Treated by Open Reduction and Internal Fixation

International Scholarly Research Notices ◽

10.1155/2014/589538 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Kavin Khatri ◽

Devendra Lakhotia ◽

Vijay Sharma ◽

G. N. Kiran Kumar ◽

Gaurav Sharma ◽

...

Keyword(s):

Internal Fixation ◽

Wound Infection ◽

Open Reduction ◽

Tibial Plateau ◽

Oxford Knee Score ◽

High Energy ◽

Tibial Plateau Fractures ◽

Functional Evaluation ◽

Schatzker Type ◽

Type V

Objective. To review functional outcome in high energy tibial plateau fractures treated by plating. Design. Retrospective analysis. Material and Methods. Sixty-five patients with Schatzker type V and type VI tibial plateau fractures treated with open reduction and internal fixation using plates were included in the study. The functional evaluation of the patients was carried out with Oxford knee scoring. Results. Fifty-four cases (83%) had Oxford knee score between 40 and 48. Seven (10.7%) had score between 30 and 39, three (4.6%) had score between 20 and 29, and one patient (1.5%) had a score of 18. Delayed union was seen in two cases and nonunion was seen in one case. The superficial wound infection was noticed in (9.2%) patients which was resolved with regular dressings and oral antibiotics. Three (4.6%) patients had developed deep wound infection and one among them had developed osteomyelitis. Conclusion. Open reduction and internal fixation in high energy tibial plateau fractures can provide good functional results in appropriately selected cases.

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Long Term Outcomes after Arthroscopic Management of Tibial Plateau Fractures

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-007-6114-9 ◽

2007 ◽

Vol 34 (1) ◽

pp. 49-54 ◽

Cited By ~ 1

Author(s):

Marc-Antoine Rousseau ◽

Gregory Biette ◽

Franck Jouve ◽

Nicolas Graveleau ◽

Philippe Hardy

Keyword(s):

Tibial Plateau ◽

Tibial Plateau Fractures ◽

Long Term Outcomes ◽

Arthroscopic Management

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Long-term outcomes after open reduction and internal fixation of bicondylar tibial plateau fractures

Injury ◽

10.1016/j.injury.2020.03.003 ◽

2020 ◽

Vol 51 (4) ◽

pp. 1097-1102

Author(s):

Yassine Ochen ◽

Jesse Peek ◽

Michael F. McTague ◽

Michael J. Weaver ◽

Detlef van der Velde ◽

...

Keyword(s):

Internal Fixation ◽

Open Reduction ◽

Tibial Plateau ◽

Tibial Plateau Fractures ◽

Long Term Outcomes ◽

Bicondylar Tibial Plateau

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Functional outcome of Schatzker type V and VI tibial plateau fractures managed with open reduction internal fixation using dual plates

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20173215 ◽

2017 ◽

Vol 3 (5) ◽

pp. 961

Author(s):

Saranjeet Singh Jagdev ◽

Subodh Kumar Pathak ◽

Abhijeet Salunke ◽

Pritam Maheshwari ◽

Prahlad Ughareja ◽

...

Keyword(s):

Internal Fixation ◽

Functional Outcome ◽

Open Reduction ◽

Tibial Plateau ◽

Oxford Knee Score ◽

Tibial Plateau Fractures ◽

Schatzker Type ◽

The Mean ◽

Type V

Background: Complex tibial plateau fractures remain a challenge to even the most experienced surgeons. These injuries usually affect the young population in their productive years thereby causing socioeconomic impact. We performed a retrospective study to evaluate the functional outcome of of Schatzker type V and VI managed through open reduction and internal fixation.Methods: 26 patients with Schatzker type V and type VI tibial plateau fractures treated with open reduction and internal fixation using plates were included in the study. Three patients were lost to follow up, 23 patients were evaluated in the final analysis. The preoperative, intraoperative data was noted from the indoor files.The final evaluation was done using Oxford knee score and VAS score.Results: There were nine Schatzker type V fractures and 14 patients with Schatzker type VI fractures. The mean duration of follow-up was 68.32 months ranging from 41 months to 126 months. The mean Oxford knee score was 39.78. Patients with Schatzker type VI had mean OKS of 37.7.The mean MPTA and mean PPTA were 88.75 degrees and 7.35 degrees respectively. Average VAS Score was 2.8 ranging from 1 to 3.9. All patients returned to their pre-injury level of activity and employment. There were no patients of deep infection. Conclusions: We conclude that open reduction and internal fixation of high-energy tibial plateau fractures gives excellent to good functional outcome with minimal soft tissue complications. The complications can be minimized with proper patient selection and soft tissue dissection.

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