scholarly journals Operative management of tibial plateau fractures: an assessment of functional and radiological outcomes with Rasmusssens scoring system

2017 ◽  
Vol 3 (6) ◽  
pp. 1092
Author(s):  
Yeshwanth Subash ◽  
Ilavarasan M. Dhamu ◽  
Jagadeesh B. ◽  
Preethi N. ◽  
Manoj Jayaram ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Bone Grafting ◽  
Scoring System ◽  
Tibial Plateau ◽  
Articular Surface ◽  
Weight Bearing ◽  
Early Mobilization ◽  
Functional Results ◽  
Tibial Plateau Fractures ◽  
Stable Internal Fixation

<p class="abstract"><strong>Background:</strong> Fractures of the proximal tibia involve a major weight bearing joint and are intra-articular injuries which frequently result in functional impairment. They require an accurate reduction of the articular surface with stable internal fixation. If these fractures are not managed appropriately, they often result in high rates of morbidity in the form of knee stiffness and arthritis. This study was done to assess the functional and radiological outcomes following various surgical modalities and to compare them with other studies as available in literature.</p><p class="abstract"><strong>Methods:</strong> 30 patients with tibial plateau fractures treated by various surgical modalities at Saveetha Medical College and Hospital were studied from January 2013 to February 2015 and were followed up for a minimum period of 6 months. Functional and radiological outcomes were assessed by the Rasmussens scoring system.<strong></strong></p><p class="abstract"><strong>Results:</strong> All 30 patients fulfilling the inclusion criteria were thoroughly evaluated and were taken up for surgery with various modalities of fixation which included cannulated cancellous screws, T and L buttress plates and locking compression plates. Articular surface elevation with bone grafting was done in depressed fractures. Early knee mobilization was started and strict non-weight bearing walking was advocated. We had a 90% acceptable functional result which was comparable with other studies.</p><p><strong>Conclusions:</strong> In our study, we conclude that accurate reduction of the articular surface with stable internal fixation and early mobilization with bone grafting in depressed fractures with protracted weight bearing till fracture union gives good functional results. Also radiological values often do not often correlate well with functional outcomes. </p>

scholarly journals Arthroscopic Assisted Reduction and Internal Fixation of Tibial Plateau Fractures

2019 ◽  
Vol 7 (7) ◽  
pp. 1133-1137 ◽  
Author(s):  
Sherif Hamdy Mohamed Zawam ◽  
Ahmed Mahmoud Gad
Keyword(s):  
Internal Fixation ◽  
Tibial Plateau ◽  
Articular Surface ◽  
Knee Injuries ◽  
Tibial Plateau Fractures ◽  
Type I ◽  
Type Ii ◽  
University Hospitals ◽  
Type Iii ◽  
Schatzker Type

BACKGROUND: Tibial plateau fractures present an important entity in orthopaedic fractures. Arthroscopic-assisted reduction and internal fixation is a good alternative to ORIF as it has the advantage of direct visualisation of the articular surface of the plateau, direct assessment of the reduction of the articular surface, and managing any associated intra-articular pathology. AIM: Our study aim is to determine the results of arthroscopic assisted reduction and internal fixation of tibial plateau fractures. METHODS: This study involved 25 patients with tibial plateau fractures presenting to the emergency department of Cairo University Hospitals between the periods of November 2016 and May 2017. The patients were followed up for an average of 14 months (11-18 months). According to Schatzker’s classification, five patients had type I, eleven had type II, and nine patients had type III fractures. RESULTS: The average time to full union in Schatzker type I was 9.1 weeks, in type II was 10.2 weeks, and in type III it was 9.4. The mean clinical Rasmussen score among the 25 patients was 26 (range, 24-30). A group of 19 patients (76%) had excellent results, (4 type I, 8 types II, and 7 types III) 6 patients (24 %) had good results (1 type I, 3 types II, 2 types III). Radiologic results were excellent in (14 cases) 56.0% and good results (11 cases) 44%. CONCLUSION: Arthroscopic assisted reduction and fixation of tibial plateau fractures have the advantages of checking the adequacy of reduction, avoiding the need for detachment of the meniscus, and allowing for accurate diagnosis and management of associated knee injuries. Therefore, we recommend that arthroscopic assisted reduction and fixation of tibial plateau fractures should be used more often.

scholarly journals An evaluation of functional outcome following surgical management of fractures of the proximal humerus with Neer’s scoring system

2017 ◽  
Vol 4 (1) ◽  
pp. 46
Author(s):  
Yeshwanth Subash ◽  
Lydia M. ◽  
Kamalakumar K. ◽  
Ilavarasan M. Dhamu
Keyword(s):  
Functional Outcome ◽  
Surgical Management ◽  
Scoring System ◽  
Soft Tissues ◽  
Proximal Humerus ◽  
Articular Surface ◽  
Treatment Options ◽  
Early Mobilization ◽  
Functional Results ◽  
Non Union

<p class="abstract"><strong>Background:</strong> <span lang="EN-GB">Fractures of the proximal humerus are complex injuries associated with significant morbidity. Various options are available for management including non-operative treatment, depending upon the pattern of the fracture, quality of the bone and the surgeon's familiarity with the techniques. The age of the patient, physical activity and the medical fitness also largely influence the treatment options. The aim of this study was to evaluate the functional outcome following surgical management of these fractures and to compare the results with studies as available in literature</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-GB">30 patients with fractures of the proximal humerus managed by surgical means were studied from January 2012 to January 2014 and were followed up for a minimum period of two years</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-GB">All the fractures treated united clinically by 8 weeks and radiologically by 16 weeks. There were no cases of delayed or non-union in our series. The fractures were more common in men with a gender distribution of 1.3:1 and were also more common in the age group of 50 to 65 years (53%). As per the Neer’s scoring system, 60% patients had excellent results while 33% patients had satisfactory results. They were all pain free and successfully returned to their pre-injury work. 6% patients had an unsatisfactory result</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-GB">Surgical management of proximal humerus fractures following the principles of articular surface reconstruction, restoration of the anatomy, stable fixation, with minimal injury to the soft tissues and early mobilization, gives good functional results</span><span lang="EN-IN">.</span></p>

Immediate Open Reduction and Internal Fixation in Open Ankle Fractures

2006 ◽  
Vol 96 (2) ◽  
pp. 120-124 ◽  
Author(s):  
Deepak Joshi ◽  
Davindar Singh ◽  
Juned Ansari ◽  
Yadu Lal
Keyword(s):  
Internal Fixation ◽  
Early Mobilization ◽  
Functional Results ◽  
Ankle Fractures ◽  
Anatomical Reduction ◽  
Ankle Stiffness ◽  
Loss Of Reduction ◽  
Superficial Skin ◽  
Grade Ii ◽  
Stable Internal Fixation

In this prospective study, 30 patients (28 men and 2 women) with open ankle fractures were treated with early debridement and immediate stable internal fixation after anatomical reduction to achieve better functional results after early mobilization. The procedure was performed an average of 8 hours (range, 6–15 hours) after injury. According to the classification system of Gustilo and Anderson, 11 fractures (37%) were grade I, 12 (40%) were grade II, 5 (17%) were grade IIIA, and 2 (7%) were grade IIIB. Six complications occurred: four patients had superficial skin necrosis and two had loss of reduction, resulting in residual ankle stiffness. Twenty patients had excellent results, eight had good results, and two had fair results according to the modified criteria of Ketenjian and Shelton. We found that immediate debridement, anatomical reduction, and internal fixation of open ankle fractures leads to better functional results, especially in grade I and grade II injuries. (J Am Podiatr Med Assoc 96(2): 120–124, 2006)

Combination of Fine Wire Fixation and Limited Internal Fixation for High-Energy Tibial Plateau Fractures: Functional Results at Minimum 5-Year Follow-up

2009 ◽  
Vol 23 (7) ◽  
pp. 493-501 ◽  
Author(s):  
Dimitris Katsenis ◽  
George Dendrinos ◽  
Antonis Kouris ◽  
Nikos Savas ◽  
Nikos Schoinochoritis ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Tibial Plateau ◽  
Functional Results ◽  
High Energy ◽  
Tibial Plateau Fractures ◽  
Fine Wire ◽  
Wire Fixation

scholarly journals Augmentation by Rafting Screw on Fixation of the Lateral Tibial Plateau Fractures

2020 ◽  
pp. 256-271
Author(s):  
Osama El Sayed Ali Hegazy ◽  
Mohamed Abd El Hameid Romeih ◽  
Ashraf Atef Mahmoud ◽  
Nabil Omar Gharbo
Keyword(s):  
Internal Fixation ◽  
Bone Grafting ◽  
Scoring System ◽  
Open Reduction ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Type Ii ◽  
Type Iii ◽  
Schatzker Type ◽  
Plateau Fracture

Background: Tibial plateau fracture is considered one of the most common intra-articular fractures, especially lateral condyle fractures. The purpose of this study is to evaluate clinical, radiological, and functional outcomes of using subchondral periarticular rafting screw above a lateral plate without bone grafting or substitute for Schatzker type II and type III fractures. Methods: This prospective study was carried out on 43 patients above the age of 18, fit for surgery with closed tibial plateau fracture [lateral split depression (type II) and lateral depression (type III) according to Schatzker classification] time of trauma less than 14 days with no other skeletal injuries. All patients were followed up for at least six months. All patients were treated by open reduction and internal fixation (ORIF) and using subchondral periarticular screws as rafting construct to maintain articular surface and protect it from collapse. Analysis of clinical outcome was clinically based on Modified Rasmussen clinical scoring system and radiologically based on Rasmussen radiological knee scoring system. Results: In our study, 28 females and 15 males with a mean age of 49.5 years, mechanisms of trauma were road traffic accidents in 26 cases, and fall from height in 17 cases, 24 cases with Schatzker type II fracture, and 19 with type III. According to functional Rasmussen score, acceptable results were 93.1%, (76.8% excellent & 11.6% good) while non-acceptable results were 6.9%, (4.6% fair & 2.3% poor). According to radiological Rasmussen score, acceptable results were 83.7%, (65% excellent & 18.7% good) while non-acceptable results were 16.3%, (9.3% & 7%). No significant difference was found between the studied groups regarding sex, side affected, type of fracture, and type of trauma. The final outcome was significantly affected by age, medical history. Conclusions: Fixation using a subchondral periarticular rafting screws for lateral split-depression and lateral depression tibial plateau fractures without using bone graft or bone substitutes is a viable and good option during open reduction and internal fixation, helps surgeons achieve and preserve the anatomic joint line and normal mechanical axis, with superior functional results in the short term. Therefore, avoiding morbidity associated with bone grafting without compromising the fracture stability.

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>

scholarly journals Arthroscopically assisted osteosynthesis of tibial plateau fracture, Schatzker type III: Case report

2021 ◽  
Vol 2 (1) ◽  
pp. 39-52
Author(s):  
Nemanja Jovanović ◽  
Lazar Mičeta ◽  
Dejan Aleksandrić ◽  
Nikola Bogosavljević ◽  
Nemanja Slavković
Keyword(s):  
Case Report ◽  
Internal Fixation ◽  
Tibial Plateau ◽  
Weight Bearing ◽  
Full Range ◽  
Surgical Techniques ◽  
Tibial Plateau Fractures ◽  
Type Iii ◽  
Schatzker Classification ◽  
Arthroscopically Assisted

Introduction. Tibial plateau fractures are complex injuries that, in most cases, require surgical treatment in order to prevent far-reaching consequences for the functionality and quality of life of the patient. While numerous surgical techniques have been described, it is evident that the technique of arthroscopically assisted repositioning (reduction) and internal fixation has the potential to take the lead in the management of these types of injuries. Case report. We present the case of a 36-year-old patient injured in a traffic accident with a fracture of the left tibial plateau, type III by Schatzker classification. After the diagnostic procedures and preparation, the patient was operated on using arthroscopically assisted repositioning (reduction) and internal fixation, with the filling of the bone defect with a combination of allogenic and synthetic bone graft. No other intra-articular injuries were diagnosed intraoperatively. The postoperative recovery went without complications, and after a period of 10 weeks of non-weight bearing and functional rehabilitation, the fracture healed completely, while the patient regained full range of motion in the knee. Conclusion. Although this type of injury has traditionally been treated with open surgery, we believe that minimally invasive surgery is the future, when it comes to tibial plateau fractures Schatzker types I-III. There is still not enough data in the literature regarding the long-term outcomes of this type of treatment, but the early postoperative results are extremely encouraging since this surgical technique enables faster recovery and fewer postoperative complications.

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