Posteromedial fragment fixation through Lobenhoffer approach in tibial plateau fractures

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

Genij Ortopedii ◽

10.18019/1028-4427-2021-27-3-313-318 ◽

2021 ◽

Vol 27 (3) ◽

pp. 313-318

Author(s):

A.G. Karasev ◽

◽

A.S. Zhdanov ◽

E.O. Darvin ◽

T.Yu. Karaseva ◽

...

Keyword(s):

External Fixation ◽

Functional Outcomes ◽

Tibial Plateau ◽

Oxford Knee Score ◽

Tibial Plateau Fractures ◽

Knee Score ◽

Long Term Outcomes ◽

Schatzker Type ◽

Bicondylar Fractures

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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Effects of Early Weight Bearing on Rehabilitation Outcomes in Patients With Traumatic Ankle and Tibial Plateau Fractures

Case Medical Research ◽

10.31525/ct1-nct04028414 ◽

2019 ◽

Author(s):

Keyword(s):

Tibial Plateau ◽

Weight Bearing ◽

Tibial Plateau Fractures ◽

Early Weight Bearing ◽

Rehabilitation Outcomes

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

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-017-4428-7 ◽

2017 ◽

Vol 26 (3) ◽

pp. 756-761 ◽

Cited By ~ 2

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

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The Long-Term Functional Outcome of Operatively Treated Tibial Plateau Fractures

Journal of Orthopaedic Trauma ◽

10.1097/00005131-200106000-00002 ◽

2001 ◽

Vol 15 (5) ◽

pp. 312-320 ◽

Cited By ~ 152

Author(s):

David G. Stevens ◽

Rani Beharry ◽

Michael D. McKee ◽

James P. Waddell ◽

Emil H. Schemitsch

Keyword(s):

Functional Outcome ◽

Tibial Plateau ◽

Tibial Plateau Fractures

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

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20160709 ◽

2016 ◽

Vol 2 (1) ◽

pp. 5 ◽

Cited By ~ 2

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

Background: 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.Methods: 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.Results: 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.Conclusions: 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.

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Long term functional outcome of operatively treated tibial plateau fractures.

Journal of Orthopaedic Trauma ◽

10.1097/00005131-199905000-00043 ◽

1999 ◽

Vol 13 (4) ◽

pp. 295-296 ◽

Cited By ~ 1

Author(s):

D Stevens ◽

R Beharry ◽

J P Waddell ◽

E H Schemitsch

Keyword(s):

Functional Outcome ◽

Tibial Plateau ◽

Tibial Plateau Fractures

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Early Weight Bearing of Lateral Tibial Plateau Fractures

Clinical Orthopaedics and Related Research ◽

10.1097/00003086-199309000-00032 ◽

1993 ◽

Vol 294 ◽

pp. 232-237 ◽

Cited By ~ 39

Author(s):

David Segal ◽

Arati R. Mallik ◽

Merrick J. Wetzler ◽

Albert V. Franchi ◽

George P. Whitelaw

Keyword(s):

Tibial Plateau ◽

Weight Bearing ◽

Tibial Plateau Fractures ◽

Lateral Tibial Plateau ◽

Early Weight Bearing

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Mid- to long-term functional outcome after open reduction and internal fixation of tibial plateau fractures

Injury ◽

10.1016/j.injury.2015.05.035 ◽

2015 ◽

Vol 46 (8) ◽

pp. 1608-1612 ◽

Cited By ~ 46

Author(s):

R.L.M. van Dreumel ◽

B.P.W. van Wunnik ◽

L. Janssen ◽

P.C.G. Simons ◽

H.M.J. Janzing

Keyword(s):

Internal Fixation ◽

Functional Outcome ◽

Open Reduction ◽

Tibial Plateau ◽

Tibial Plateau Fractures

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Functional outcome of intertrochanteric fractures treated with bipolar hemiarthroplasty

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20164392 ◽

2016 ◽

Vol 3 (1) ◽

pp. 1

Author(s):

Rahul Kadam ◽

Ritesh Sawant ◽

Abhay Chhallani

Keyword(s):

Elderly Patients ◽

Functional Outcome ◽

Weight Bearing ◽

Treatment Modalities ◽

Bipolar Hemiarthroplasty ◽

Intertrochanteric Fractures ◽

Early Weight Bearing ◽

Non Union ◽

Cemented Bipolar Hemiarthroplasty ◽

Metal Failure

Background: Comminuted intertrochanteric fractures with severe displacement are common in elderly patients. These patients have poor bone quality and conventional osteosynthetic procedures frequently lead to non-union and metal failure. The primary goals of treatment are stable fixation and early rehabilitation. There are a many treatment for intertrochanteric fractures but our study is on unstable intertrochanteric fractures which are challenging for a surgeon. The aim of this study was to evaluate the results of cemented bipolar hemiarthroplasty as an alternative to other treatment modalities such as DHS or PFN. 21 elderly patients with comminuted and unstable intertrochanteric fractures underwent cemented bipolar hemiarthroplasty.Methods: This study includes 22 cases of intratrochantric fracture. Mean age of patients was 73.3 (range 60 - 91). All patients are treated with bipolar hemiarthoplasty. Patients are followed up for a mean period of 6 months (range 3-9 months).Results: These patients were evaluated using the Harris hip scoring system. 21 out of 22 had excellent to fair outcomes. Conclusions: In our study of 22 patients, 21 had excellent to fair outcomes with primary cemented bipolar hemiarthroplasty. Bipolar hemiarthoplasty offers good functional outcome and early weight bearing and mobilization.

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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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