scholarly journals Evaluation of functional outcome of tibial plateau fractures managed by different surgical modalities

2016 ◽  
Vol 2 (1) ◽  
pp. 5 ◽  
Author(s):  
Ravi kant Jain ◽  
Rajeev Shukla ◽  
Mudit Baxi ◽  
Utkarsh Agarwal ◽  
Sankalp Yadav
Keyword(s):  
Functional Outcome ◽  
Fracture Fixation ◽  
Traffic Accidents ◽  
Tibial Plateau ◽  
Road Traffic ◽  
Wide Spectrum ◽  
Weight Bearing ◽  
Age Groups ◽  
Fracture Morphology ◽  
Tibial Plateau Fractures

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>Tibial plateau makes up one of the most important weight bearing surface. Its fractures are commonly faced entity encompassing a wide spectrum of injuries of variable fracture morphology. Due to in-crease in incidence of high velocity trauma and higher functional demands of patients, surgery is warranted in most of the cases. Although, there is advancement in fracture fixation methods, apt treatment of tibial plateau fractures still remains controversial.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong><span lang="EN-US"> In our series, we analyzed the functional outcomes of 58 of surgically treated tibial plateau fractures. Fractures were classified with Schatzker’s classification. Various fixation modalities of fixation were employed. Functional outcome was evaluated with modified Rasmussen’s criteria.<strong></strong></span></p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>Most of the patient’s belonged to younger age groups (58.62%) and males (79.31%) were predominately involved. Road traffic accidents were the most common etiological factor (70.69%). Schatzker types I (29.31%) and II (27.59%) were the most common observed fracture type. The majority of the patients had a complication free recovery (81.03%). Infection was reported in only one case (1.72%). Similarly, malunion was noticed in only in one case (1.72%). None of the patients had complications like nonunion or neurovascular damage. The functional outcome assessment according to Modified Rasmussen’s criteria at the end of 12 months showed the excellent functional outcome in 41 (70.68%), good in eight (13.79%), fair in five (10.34%) and poor in four (6.9%) patients.</p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>Surgical treatment of tibial plateau fractures is challenging, yet it helps in achieving excellent anatomical restoration and rigid fracture fixation enabling in the restoration of articular congruity and facilitation of early knee motion thus achieving optimal knee function.</p>

scholarly journals A prospective study of functional outcome of closed schatzker type V and type VI tibial plateau fractures managed by open reduction and internal fixation

2020 ◽  
Vol 11 (SPL2) ◽  
pp. 137-144
Author(s):  
Ramkumar G ◽  
Ilavarasan Mangadu Dhamu ◽  
Anindya Debnath ◽  
Dinesh R ◽  
Sugumar N ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Tibial Plateau ◽  
Road Traffic ◽  
Weight Bearing ◽  
Cartilage Regeneration ◽  
Tibial Plateau Fractures ◽  
Pelvic Injury ◽  
Schatzker Type ◽  
Type V ◽  
Tibia Plateau

Knee joints comprised of the distal femur, proximal tibia & patella. Injuries of the knee must be treated properly to maintain a good knee function. Fractures of the tibia plateau represent 1% of all fractures and approximately 8% of fractures occurring in the elderly. The aim was tostudy the “functional outcome of treatment of closed schatzker type V and type VI tibial plateau fractures using locking compression plate”. In this study, twenty patients with tibia plateau fractures who presented to our casualty were studied. All the patients were victims of road traffic accidents. Once they were thermodynamically stable, were clinically examined and assessed for associated injuries.Out of 11 patients with Type VI fractures, 4(36%) had excellent results, 4(36%) had good results, 2(18%) had fair results and 1(9%) had poor results. The poor result was due to the associated pelvic injury, which interrupted the regular post-op rehabilitation. Out of 9 patients with type V fractures, 2(22%) had excellent results and 7(78%) had good results according to Rasmussen Radiologic Assessment. Hence,early mobilization is absolutely essential for preventing the knee stiffness & for quick articular cartilage regeneration. Weight-bearing should be delayed until solid union to prevent the articular collapse.

scholarly journals Posteromedial fragment fixation through Lobenhoffer approach in tibial plateau fractures

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

<p class="abstract"><strong>Background:</strong> <span lang="EN-GB">Management of tibial plateau fractures with coronal fractures especially posteromedial fragment is frequent and challenging. This study was conducted to </span><span lang="EN-IN">evaluate the</span><span lang="EN-GB"> functional outcome of patients with tibial plateau fractures having posteromedial fragment treated with open reduction and internal fixation (ORIF) using Lobenhoffer approach</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-GB">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</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-GB">The mean </span><span lang="EN-IN">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. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-GB">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</span><span lang="EN-IN">.</span></p>

scholarly journals A STUDY OF MANAGEMENT OF PROXIMAL THIRD TIBIAL FRACTURES USING MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS (MIPPO) WITH LOCKING COMPRESSION PLATES

2020 ◽  
pp. 21-22
Author(s):  
P. Krishna Chaitanya ◽  
Chopparapu. Tulasi Mahesh
Keyword(s):  
Traffic Accidents ◽  
Tibial Plateau ◽  
Road Traffic ◽  
Plate Osteosynthesis ◽  
Axial Loading ◽  
The Elderly ◽  
Tibial Plateau Fractures ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Industrial Accidents ◽  
Articular Fractures

The Tibial plateau fractures are one of the most prevalent intra-articular fractures. Tibial plateau fractures occur due to strong valgus or varus forces combined with axial loading, i.e., fall from a height, road traffic accidents, industrial accidents, athletics, or minor injuries like stumbling, falling from steps. The Tibial plateau fractures constitute 1% of all fractures and 8% of fractures in the elderly. Isolated lateral plateau fractures constitute 55% to 70% of tibial plateau fractures. 10% to 25% are isolated medial plateau fractures, and the rest 10% to 30% are bicondylar fractures1.

scholarly journals Functional and radiological evaluation of surgical management in tibial plateau fractures: a prospective study

2018 ◽  
Vol 4 (2) ◽  
pp. 261
Author(s):  
Sreenath Rao Jakinapally ◽  
Sridhar Reddy Konuganti ◽  
Vennamaneni Pratish Rao ◽  
Sivaprasad Rapur
Keyword(s):  
Prospective Study ◽  
Tibial Plateau ◽  
Road Traffic ◽  
Articular Surface ◽  
Weight Bearing ◽  
Tertiary Care ◽  
Surgical Care ◽  
Tibial Plateau Fractures ◽  
Rigid Fixation ◽  
Schatzker Classification

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Tibial plateau fractures affect knee which is a major weight bearing joint, altering its contribution to stability and its function. Regardless of the advancements in technique and implants, ideal mode of management is still contentious.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This prospective study reviewed 20 consecutive cases of tibial plateau fractures managed surgically by various modes of internal fixation from November 2012 to June 2014 in the Department of orthopaedics at Mediciti Institute of medical sciences, Ghanpur, Medchal, a tertiary care referral and trauma center</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">This study comprised higher number of fractures type II and type IV Schatzker classification, with mean age of 37.75 years. Most frequent mode of injury is Road traffic accident in n=17 out of n=20 patients (85%). Mean gain in flexion of 113.33 degree. Mean score of 27.15 and 9.70 under modified Rasmussen criteria for clinical assessment and radiological assessment respectively at 6 months. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Optimal outcome from surgical care of tibial plateau fracture is acquired when precise articular surface reconstruction with elevation of depressed bone fragment, and bone grafting when necessary, associated with rigid fixation which permits early physiotherapy and return to function. Deficiency of excellent results among type V and type VI fractures are often secondary to inadequate reconstruction and collapse of articular restoration post operatively.</span></p>

An intact fibula may contribute to allow early weight bearing in surgically treated tibial plateau fractures

2017 ◽  
Vol 26 (3) ◽  
pp. 756-761 ◽  
Author(s):  
Ion Carrera ◽  
Pablo Eduardo Gelber ◽  
Gaetan Chary ◽  
Mireia Gomez Masdeu ◽  
Miguel A. González Ballester ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Weight Bearing ◽  
Tibial Plateau Fractures ◽  
Early Weight Bearing

Children and Terror Casualties Receive Preference in ICU Admissions

2012 ◽  
Vol 6 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Kobi Peleg ◽  
Michael Rozenfeld ◽  
Eran Dolev ◽  
Keyword(s):  
Traffic Accidents ◽  
Injury Severity ◽  
Road Traffic ◽  
Age Groups ◽  
Trauma Patients ◽  
Trauma Centers ◽  
Severe Injuries ◽  
Level I ◽  
Hospital Emergency Departments ◽  
Trauma Type

ABSTRACTObjective: Trauma casualties caused by terror-related events and children injured as a result of trauma may be given preference in hospital emergency departments (EDs) due to their perceived importance. We investigated whether there are differences in the treatment and hospitalization of terror-related casualties compared to other types of injury events and between children and adults injured in terror-related events.Methods: Retrospective study of 121 608 trauma patients from the Israel Trauma Registry during the period of October 2000-December 2005. Of the 10 hospitals included in the registry, 6 were level I trauma centers and 4 were regional trauma centers. Patients who were hospitalized or died in the ED or were transferred between hospitals were included in the registry.Results: All analyses were controlled for Injury Severity Score (ISS). All patients with ISS 1-24 terror casualties had the highest frequency of intensive care unit (ICU) admissions when compared with patients after road traffic accidents (RTA) and other trauma. Among patients with terror-related casualties, children were admitted to ICU disproportionally to the severity of their injury. Logistic regression adjusted for injury severity and trauma type showed that both terror casualties and children have a higher probability of being admitted to the ICU.Conclusions: Injured children are admitted to ICU more often than other age groups. Also, terror-related casualties are more frequently admitted to the ICU compared to those from other types of injury events. These differences were not directly related to a higher proportion of severe injuries among the preferred groups.(Disaster Med Public Health Preparedness. 2012;6:14–19)

scholarly journals SPECTRUM AND OUTCOME OF BLUNT ABDOMINAL TRAUMA

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Mahesh Kumar Sharma ◽  
Dr. Arun Bhargava
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Traffic Accident ◽  
Traffic Accidents ◽  
Splenic Injury ◽  
Road Traffic ◽  
Age Groups ◽  
Operative Management ◽  
Fall From Height ◽  
Type Of Injury

Background: Blunt abdominal trauma is a leading cause of morbidity and mortality among all age groups. So we evaluate the spectrum and outcome of blunt trauma. Methods: Hospital based prospective study conducted on 100 patients at department of general surgery. Results: Distribution according to type of injury consisted of maximum cases, 84 (84%) of road traffic accidents, 11% cases were of fall from height. Conclusions: Males were pre-dominantly affected. Road traffic accident was the most common cause of injury. Though conservative management is successful in carefully selected patients, operative management remains the main stay of treatment. Keywords: Blunt abdominal trauma, Liver injury, Perforation, Splenic injury

Mapping recovery in simple and complex tibial plateau fracture fixation

2019 ◽  
Vol 101-B (8) ◽  
pp. 1009-1014 ◽  
Author(s):  
D. N. Ramoutar ◽  
K. Lefaivre ◽  
H. Broekhuyse ◽  
P. Guy ◽  
P. O’Brien
Keyword(s):  
Functional Outcome ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Short Form ◽  
Tibial Plateau Fractures ◽  
Functional Score ◽  
Complex Group ◽  
Sf 36 ◽  
Functional Scores ◽  
Plateau Fracture

Aims The aim of this study was to determine the trajectory of recovery following fixation of tibial plateau fractures up to five-year follow-up, including simple (Schatzker I-IV) versus complex (Schatzker V-VI) fractures. Patients and Methods Patients undergoing open reduction and internal fixation (ORIF) for tibial plateau fractures were enrolled into a prospective database. Functional outcome, using the 36-Item Short Form Health Survey Physical Component Summary (SF-36 PCS), was collected at baseline, six months, one year, and five years. The trajectory of recovery for complex fractures (Schatzker V and VI) was compared with simple fractures (Schatzker I to IV). Minimal clinically important difference (MCID) was calculated between timepoints. In all, 182 patients were enrolled: 136 (74.7%) in simple and 46 (25.3%) in complex. There were 103 female patients and 79 male patients with a mean age of 45.8 years (15 to 86). Results Mean SF-36 PCS improved significantly in both groups from six to 12 months (p < 0.001) and one to five years (simple, p = 0.008; complex, p = 0.007). In both groups, the baseline scores were not reached at five years. The SF-36 PCS was significantly higher in the simple group compared with the complex group at both six months (p = 0.007) and 12 months (p = 0.01), but not at five years (p = 0.17). Between each timepoint, approximately 50% or more of the patients in each group achieved an MCID in their score change, indicating a significant clinical change in condition. The complex group had a much larger drop off in the first six months, with comparable proportions achieving MCID at the subsequent time intervals. Conclusion Tibial plateau fracture recovery was characterized overall by an initial decline in functional outcome from baseline, followed by a steep improvement from six to 12 months, and ongoing recovery up to five years. In simple patterns, patients tended to achieve a higher functional score by six months compared with the complex patterns. However, comparable functional scores between the groups achieved only at the five-year point suggest later recovery in the complex group. Function does not improve to baseline by five years in either group. This information is useful in counselling patients about the course of prospective recovery. Cite this article: Bone Joint J 2019;101-B:1009–1014.

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