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 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 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 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 Various modalities of treatment of proximal tibial fractures: a prospective longitudinal study

2017 ◽  
Vol 3 (2) ◽  
pp. 259
Author(s):  
Yash B. Rabari ◽  
Ashish M. Somanni ◽  
D. V. Prasad ◽  
Krunal H. Thadeshwar
Keyword(s):  
Tibial Plateau ◽  
Road Traffic ◽  
Tibial Plateau Fractures ◽  
Clear Understanding ◽  
Fracture Type ◽  
Prospective Longitudinal Study ◽  
Articular Fractures ◽  
Tibial Condyle ◽  
Schatzker Classification ◽  
Prospective Longitudinal

<p class="abstract"><strong>Background:</strong> Tibial plateau fractures are one of the commonest intra-articular fractures. They result from indirect coronal or direct axial compressive forces. This makes about 1% of all fractures and 8% of the fractures in elderly. Nevertheless, tibial plateau fractures challenging remain because of their number, variety and complexity. With advancements the treatment of each fracture type is still not defined hence we have taken up this study to analyze various fracture patterns and its outcome.</p><p class="abstract"><strong>Methods:</strong> The study includes 40 patients having the fractures of  the proximal tibial metaphyseal; metaphyseodiaphyseal with or without intra-articular extension (including upper third fractures of tibia), closed fractures, fractures with Open grade-I wounds (Gustillo Anderson Classification).The study excludes compound fractures having grade II and III (Gustillo Anderson) and Paediatric patients. The treatment  method  was  based  on  the  type  of  fracture,  the  amount  of displacement , the amount of depression and surrounding skin condition  of the tibial plateau. We used the Schatzker classification because it is closest to describing the specific fracture type and it is easy to apply.<strong></strong></p><p class="abstract"><strong>Results:</strong> In this study there were 40 patients with mean age of 39.18 (median 38.5 and min – max 25 to 55) with 25 male (62.5%) and 15 (37.5%) female with significant male preponderance. In this study road  traffic  accident  was  the  commonest  mode  of  injury  (65%)  and produced different types of fractures, followed by fall from height (22.5%), injury while playing sports (12.5%).</p><p><strong>Conclusions:</strong> The correct method of management of tibial condylar fractures depends on good clinical judgment. If rational treatment is to be instituted the surgeon must have sound knowledge of the personality of the injury and a clear understanding of the knee examination, imaging studies and must be familiar with variety of techniques available at present for treating tibial condyle fractures.</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.

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

scholarly journals Clinical Analysis of Classification for Tibial Plateau Fractures and Popliteal Artery Injury

2020 ◽  
Author(s):  
Yilun Yao ◽  
Xiaoshu Wu ◽  
Lei Wu ◽  
Lei Yang ◽  
Chunzhi Jiang ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Clinical Analysis ◽  
Tibial Plateau Fractures ◽  
Artery Injury ◽  
Type Iv ◽  
Schatzker Type ◽  
Schatzker Classification ◽  
Tibial Head ◽  
Type V

Abstract Background To explore the association between the classification for tibial plateau fractures (TPF) and the popliteal artery injury (PAI).Methods 22 TPF patients accompanied by PAI who were treated from May 2012 to July 2019 were retrospectively analyzed. There were 19 males and 3 females with an average age of 49.43 years. The Schatzker classification and three-column classification were performed for TPF. The severity of extremity injury was evaluated using the mangled extremity severity score (MESS). Except 3 patients treated with amputation, the remaining patients underwent surgical repair of popliteal artery and fracture external fixation. The outcome was evaluated using the Rasmussen score for tibial head fractures.Results There were 10 cases of Schatzker type IV fractures, 1 case of type V fractures and 11 cases of type VI fractures. Based on the three-column classification, the posterior column was involved in 22 cases, 2 columns in 15 cases and 3 columns in 6 cases. The MESS was 6-10 points, with an average of 7.59 points. Except 1 case directly receiving amputation, 3 cases of segment P1 injury was observed via preoperative DSA + intraoperative exploration, while segment P2 in 6 cases and segment P3 in 12 cases. Popliteal artery was found completely ruptured in 11 cases, partially ruptured in 1 case, and severely contused with thrombosis in 10 cases. The Rasmussen score was given to 19 patients at the last follow-up, except for the cases undergoing amputation. The outcome was satisfied in 14 cases, unsatisfied in 5 cases.Conclusion: In patients with complex TPF, the risk of PAI becomes higher with the increase of Schatzker classification level. Knee CT scan is helpful in determining the severity of fractures and evaluating PAI. Based on the three-column classification, PAI should be suspected when the fractures involve the medial and posterior column.PAI is mainly in the segment P3, and artery rupture or severe contusion with extensive thrombosis may occur.

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