scholarly journals A study of minimally invasive percutaneous plate osteosynthesis for tibial plateau fractures

2017 ◽  
Vol 4 (1) ◽  
pp. 92
Author(s):  
Ujwal S. Ramteke ◽  
Vidyadhar Telang ◽  
Nadir Shah ◽  
Ayush Singh ◽  
Hitesh Mangukiya ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Weight Bearing ◽  
Full Range ◽  
Tibial Plateau Fractures ◽  
Type I ◽  
X Rays ◽  
Age Group ◽  
Schatzker Type ◽  
Plateau Fracture

<p class="abstract"><strong>Background:</strong> <span lang="EN-GB">Fractures of proximal tibia involve a major weight-bearing joint and are serious injuries, which, if not treated well, result in functional impairment. To preserve normal knee function one must strive to maintain joint congruity, preserve the normal mechanical axis, ensure joint stability and restore a full range of motion. This is a formidable task to accomplish, especially in the face of associated medical conditions of the patients</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-GB">In our study, 30 cases were selected. Selection of cases were done on the basis of X-rays. Schatzker type I, II, III, IV, V &amp; VI included in study. Criteria for acceptable reduction 1) &lt;5 mm of articular step; 2) &lt;5 mm of articular depression. Each case is referred to one set of tibial plateau fracture, showing distribution of tibia plateau fractures that we treated with MIPPO. Clinical follow-up examination was performed at 4, 6, 10, 12 weeks and 3, 6 months. Clinico-radiological assessment was done at 3 month and grading was done. Patients were evaluated according to grading minimum 3 months after injury</span>.</p><p class="abstract"><strong>Results:</strong> <span lang="EN-GB">Our study of 30 tibial plateau fractures confirms that the MIPPO technique is an excellent treatment modality in case of tibial plateau fractures. We observed these fractures mainly in age group of 30-40 years, which were involved in road traffic accident. Tibial plateau fractures seen in elder age group were mainly due to abnormal loading patterns on the leg. We have found oblique views very much informative especially for posterolateral or posteromedial displacement, articular depression which helps to plan the position and direction of screws to be used for fixation</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-GB">In view of the excellent results obtained with this technique, we advocate MIPPO over conventional open reduction and internal fixation technique for tibial plateau fracture fixation</span><span lang="EN-IN">.</span></p>

scholarly journals Plate-screw and screw-washer stability in a Schatzker type-I lateral tibial plateau fracture: a comparative biomechanical study

2020 ◽  
Vol 47 ◽  
Author(s):  
VINCENZO GIORDANO ◽  
WILLIAM DIAS BELANGERO ◽  
BRENNO DE ARAÚJO SÁ ◽  
DANIELA RIVAS ◽  
DANILO SOUTO ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Dynamic Compression ◽  
Type I ◽  
Small Fragment ◽  
Dynamic Compression Plate ◽  
Cortical Screw ◽  
Schatzker Type ◽  
Compression Plate ◽  
Plateau Fracture

ABSTRACT The aim of this study was to evaluate the biomechanical role of both a non-locking two-hole small fragment dynamic compression plate with 3.5-mm screws and a 4.5-mm cortical screw with a washer applied to a Schatzker type-I tibial plateau fracture. Sixteen right synthetic tibiae were used to create an anterolateral shear tibial plateau fracture (Schatzker type-I fracture). Eight models were fixed with a small fragment non-locked straight dynamic compression plate with one 3.5-mm bicortical screw (plate-screw construction) and eight models were fixed with a 4.5-mm cortical screw and a washer (screw-washer construction), both inserted at 1.0 mm distal to the apex of the fracture. Specimens were tested up to the onset of yielding at a constant strain rate of 5.0-mm/min. Stiffness ranged from 311.83 N/mm to 199.54 N/mm, with a mean + SD of 260.32 + 33.8 N/mm in the plate-screw construction, and from 290.34 N/mm to 99.16 N/mm, with a mean + SD of 220.46 + 63.12 N/mm in screw-washer construction. There was no significant difference (p=0.172). Use of a two-hole small-fragment non-locked plate with one 3.5-mm cortical screw or a 4.5-mm cortical screw with a washer applied at 1.0 mm distal to the apex of the fracture as buttressing present similar stiffness in terms of preventing axial displacement in synthetic tibiae models tested up to the onset of yielding.

scholarly journals REHABILITATION OF A 60-YEAR-OLD WOMAN’S TIBIAL PLATEAU FRACTURE

2021 ◽  
Vol 10 (4) ◽  
pp. 3229-3232
Author(s):  
Mithushi Deshmukh
Keyword(s):  
Knee Joint ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Weight Bearing ◽  
Full Range ◽  
The Body ◽  
Normal Functioning ◽  
Tibial Condyle ◽  
Plateau Fracture ◽  
Condyle Fracture

Tibial plateau fracture is one of the commonest fractures which leads to the break in the continuity of the upper part of the tibia (shinbone) that involves the knee joint. It involves either lateral tibial condyle or medial tibial condyle or both. This fracture interferes with the normal functioning of the body in day-to-day life. Therefore, physiotherapy rehabilitation after surgery is essential to get back to normal functioning. A 60-year-old female who slipped from a two-wheeler started experiencing severe pain & swelling around the knee joint. Her relatives brought her to Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi, Wardha, Maharashtra. X-ray was done and she was diagnosed with lateral tibial condyle fracture (tibial plateau fracture) and then underwent open reduction internal fixation with plate osteosynthesis. Later, she was referred for physiotherapy rehabilitation, which aimed to restore mobility, regain full range of motion, develop muscle strength and build up to weight-bearing. The tibial plateau fracture is a form of fracture with a low occurrence and is a complicated fracture to treat.The above case study concludes that a traditional surgical procedure combined with timely planned physiotherapy rehabilitation contributed to progressive improvement in functional goals, which is an important factor in achieving a good recovery in such post-operative cases.

scholarly journals Posterolateral Corner Injury Associated with a Schatzker Type 2 Tibial Plateau Fracture

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Boris A. Zelle ◽  
James R. Heaberlin ◽  
Matthew C. Murray
Keyword(s):  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Treatment Options ◽  
Full Range ◽  
Posterolateral Corner ◽  
Physical Exam ◽  
Initial Assessment ◽  
Schatzker Type ◽  
Plateau Fracture

Isolated posterolateral corner (PLC) injuries are rarely seen with tibial plateau fractures and can be missed during the initial assessment. The objective of this paper is to present a case of a Schatzker type 2 tibial plateau fracture with associated isolated PLC injury and give a discussion on physical exam, diagnostic studies, and treatment options. A twenty-five-year-old female sustained a concomitant Schatzker type 2 fracture and PLC injury. Magnetic Resonance Imaging showed an isolated PLC disruption. Open reduction-internal fixation was performed with subsequent PLC repair. At sixteen months postoperatively, the patient had full range of motion and strength of her knee and no signs of laxity. This case emphasizes the importance of physical exam and appropriate imaging modalities in order to diagnose and treat this significant injury in a prompt fashion. In this case, surgical fracture fixation and subsequent repair of the PLC provided a good clinical outcome.

scholarly journals Canulated Screw Fixation for Tibial Plateau Fracture in Adults

2016 ◽  
Vol 22 (3) ◽  
Author(s):  
Faheem Ahmed Memon ◽  
Abbas Memon ◽  
Mehtab Pirwani
Keyword(s):  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Screw Fixation ◽  
Early Mobilization ◽  
Type I ◽  
Rigid Fixation ◽  
Percutaneous Screw Fixation ◽  
Severe Injuries ◽  
Schatzker Type ◽  
Plateau Fracture

<p><strong>Objective:</strong><strong>  </strong>To determine percutaneous screw fixation (PSF) as fair treatment option for Schatzker type I, closed tibial plateau fracture in adults.</p><p><strong>Patients and Methods:</strong><strong>  </strong>30 male and female adults between the ages of 20 and 40 were included. Only displaced Schatzkar type I closed tibial plateau fractures without any associated injury or complication were included. Type II, III, IV, V and VI, fractures with infection, patients with other severe injuries and neurovascular compromise fractures were excluded. Patients were followed weekly for one month, every alternate week for four months, thereafter monthly for up to six months to assess range of motion, deformity, union or any other complication.</p><p><strong>Results:</strong><strong>  </strong>Mean healing was 11.6 weeks. Mean hospital stay was 8.4 days. The overall clinical results were excellent in 20 (66.6%), good in 8 (26.6%), fair in 2 (6.6%) cases.<strong></strong></p><p><strong>Conclusion:</strong><strong>  </strong>Percutaneous screw fixation provided</p><p>better results in close displaced type I Schatzker tibial plateau fracture in adults. It is minimally invasive and achieved articular anatomical reduction, rigid fixation and early mobilization.</p>

scholarly journals Surgical Management of Tibial Plateau Fractures with Locking Compression Plate

2021 ◽  
Vol 9 (01) ◽  
pp. 18-23
Author(s):  
Bipan Shrestha ◽  
Prakriti Raj Kandel ◽  
Kishor Man Shrestha ◽  
Shreshal Shrestha ◽  
Rakesh Yadav
Keyword(s):  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Treatment Options ◽  
Locking Compression Plate ◽  
Tibial Plateau Fractures ◽  
Institutional Review ◽  
Schatzker Type ◽  
Compression Plate ◽  
Plateau Fracture ◽  
The Mean

  INTRODUCTION Tibial plateau fracture is a common fracture that accounts for 1-2% of all fracture. Various treatment options including proximal tibial plating with locking compression plates are available for the treatment of tibial plateau fracture. This study was done to determine the clinical profile and functional outcome of tibial plateau fracture following locking compression plating.   MATERIAL AND METHODS This prospective and observational study was carried out in Orthopedics Department of Universal College of Medical Sciences-Teaching Hospital (UCMS-TH) from December 2018 to July 2020. After Ethical clearance (UCMS/IRC/224/18) from Institutional Review Board (IRB) of UCMS-TH and informed written consent, all patients with tibial plateau fracture (Schatzker II-VI) who fulfilled the inclusion criteria were enrolled in the study and treated with locking compression plate. Post-operatively patients were regularly followed at 6 weeks, 3 months and 6 months for clinical, radiological and functional assessment. Descriptive statistics like frequency, percentage, mean and standard deviation were used to analyze the data.   RESULTS In our study of 30 cases, the mean age was 37.77 ±15.65 years. Most of the cases were Schatzker type VI (13 patients) and type II (9 patients). The average duration for fractures union was 23.4 ±2.1 weeks. Superficial wound infection was the common complication seen in five cases. At six months, the mean knee society score (KSS) was 78 ±7.22 and majority of patients (19 patients) had good results.   CONCLUSION Locking compression plate has an excellent functional and radiological outcome. It is an effective implant that can be adopted for the treatment of tibial plateau fractures in adults.  

scholarly journals Tibial Plateau Fracture Following Low Energy Fall in the Rocky Mountains

2019 ◽  
Vol 12 (3) ◽  
pp. 91-93
Author(s):  
Alexandra V. Arvanitakis ◽  
Kerry C. Mian ◽  
Raymond Kreienkamp ◽  
Charles E. Rhoades
Keyword(s):  
Rocky Mountains ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Weight Bearing ◽  
High Energy ◽  
Classification Systems ◽  
Tibial Plateau Fractures ◽  
Mechanism Of Injury ◽  
Direct Trauma ◽  
Plateau Fracture

Tibial plateau fractures are debilitating injuries. They can occurin younger individuals who sustain a high energy trauma or, withincreasing age, lesser degrees of trauma and underlying bone pathology such as osteoporosis, metabolic bone disease, and malignancy.1Outside these cases, tibial plateau fractures are relatively uncommon.However, these fractures can occur in healthy patients who have sustained direct trauma to the knee.Fractures of the tibial plateau often are classified according to theSchatzker or AO classification systems.2,3 These systems evaluate theinvolvement of both the medial and lateral plateaus, degree of comminution, extension into the joint, and displacement (both articularsurfaces and the relationship of the diaphysis to the metaphysis).Most tibial plateau fractures occur in the lateral aspect of the tibialplateau.1 The increased frequency of lateral fractures is due to themedial tibial plateau being able to resist higher weight-bearing loaddue to the presence of more cancellous bone. More importantly, thelateral plateau has more articular surface exposed during extensioncompared to the medial plateau, which increases likelihood of injury.4The standard of care for most displaced tibial plateau fracturesis surgical management with open reduction and internal fixation(ORIF).5 Conservative management, such as leg bracing, is an optionfor fractures that are nondisplaced or in patients too fragile for surgical intervention. In the senior population, a total knee arthroplasty(TKA) is a less common option. Tibial plateau fractures, particularlymedial tibial plateau fractures, caused by direct trauma in the elderly,non-osteoporotic population are uncommon.We present the case of an active male without overt risk for severefracture (10-year fracture risk of 10% via FRAX score) who wasworking to repair a trail in the Rocky Mountains. While other injurieswere more likely given the mechanism of injury and patient risk, thiscase highlighted the importance of considering tibial plateau fracture,even in atypical settings without significant risk. Improved awarenessof this mechanism of injury will lead to more accurate diagnosis andgreater post-injury management.

Age-Related Variances in Patients with Tibial Plateau Fractures

2019 ◽  
Vol 33 (06) ◽  
pp. 611-615 ◽  
Author(s):  
Lasun O. Oladeji ◽  
John R. Worley ◽  
Brett D. Crist
Keyword(s):  
Elderly Patients ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
The Elderly ◽  
Tibial Plateau Fractures ◽  
Mechanism Of Injury ◽  
Younger Patients ◽  
Age Related ◽  
Comorbidity Burden ◽  
Plateau Fracture

AbstractTibial plateau fractures account for approximately 8% of fractures in the elderly population. Treatment strategies in the elderly are similar to those for younger patients; however, practitioners must account for the elevated comorbidity burden in this population. To date, few studies have analyzed age-based outcomes in patients with tibial plateau fractures. Therefore, the purpose of this study was to determine age-related variances in demographics, fracture characteristics, mechanism of injury, and complications. A 10-year retrospective review was conducted to identify patients who received treatment for a tibial plateau fracture. There were 351 patients (360 tibial plateau fractures) who were identified and subsequently stratified according to their age at the time of injury. Patients were classified as elderly if they were 65 years of age or older at the time of injury; all other patients were included in the control cohort. These two cohorts were analyzed using bivariate analysis to isolate for age-related variations with respect to risk factors, mechanism of injury, and complications. There were 351 patients (360 tibial plateau fractures) with a median follow-up of 1.84 ± 2.44 years who met inclusion criteria. There were a greater proportion of women in the elderly cohort as compared with the younger cohort (60.0 vs. 43.4%, p = 0.06). Elderly patients were significantly more likely to present with diabetes (33.3 vs. 16.1%, p = 0.01) or osteoporosis (14.3 vs. 1.6%, p = 0.001). Younger patients were significantly more likely to require further surgery to address ligament (12.6 vs. 0%, p = 0.008), meniscus (20.9 vs. 7.1%, p = 0.036), or cartilage pathology (13.6 vs. 0%, p = 0.005). There was no difference in the arthroplasty conversion rate (4.8% elderly vs. 7.9% control, p = 0.755). While elderly patients presented with a greater comorbidity burden, they had equivalent or better short-term outcomes when compared with their younger peers when treated with open reduction and internal fixation (ORIF). Despite the recent interest in primary total knee arthroplasty for elderly patients with tibial plateau fractures, the results of this study suggest that elderly patients may respond well when treated with ORIF following a tibial plateau fracture.

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