The Staged Treatment for Tibial Plateau Fractures and the Reconstruction of Lateral Column With Autogenous Iliac Bone: an Efficacy Analysis Report

Abstract BackgroundComplications in treating comminuted tibial plateau fractures with extensive soft tissue damage are common. In this study, we discussed the effect of staged treatment in the reconstruction of the lateral column with autogenous iliac bone using case follow-up.MethodsA retrospective analysis of 18 patients with comminuted tibial plateau fractures and extensive soft tissue damage from October 2016 to February 2020 who underwent staged treatment in our hospital. After the soft tissue damage repair, a large autologous iliac bone was used to reconstruct the lateral column of the tibial plateau.ResultsAll 18 patients were followed up over the course of 8-40 months, with an average of 23.44 months. All patients reported zero postoperative infection, skin and soft tissue necrosis, and loosening/breakage of the internal fixation. Regular postoperative review revealed that all patients achieved complete bony union, as evidenced by X-ray film, at 6 months after operation. Knee function (HSS) scores averaged 86.72 points at 1 year after operation; 15 people with 85 points or more, 2 people with 70-84 points, and one with 68 points. The excellent rate, according to HSS was 90%.ConclusionsComplex tibial plateau fractures with extensive soft tissue damage can be effectively remedied with a staged treatment, wherein a lateral column reconstruction is performed using a large iliac bone.

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The staged treatment for tibial plateau fractures and the reconstruction of lateral column with autogenous iliac bone: an efficacy analysis report

10.21203/rs.3.rs-346348/v2 ◽

2021 ◽

Author(s):

Dong Li ◽

Xiao Liang ◽

Kun Xi ◽

Bin Zhao ◽

Fushan Hou

Keyword(s):

Soft Tissue ◽

Tissue Damage ◽

Tibial Plateau ◽

Tibial Plateau Fractures ◽

Iliac Bone ◽

Soft Tissue Damage ◽

Bony Union ◽

Lateral Column ◽

Soft Tissue Necrosis ◽

Staged Treatment

Abstract Background: Complications in treating comminuted tibial plateau fractures with extensive soft tissue damage are common. In this study, we discussed the effect of staged treatment in the reconstruction of the lateral column with autogenous iliac bone using case follow-up. Methods: A retrospective analysis of 18 patients with comminuted tibial plateau fractures and extensive soft tissue damage from October 2016 to February 2020 who underwent staged treatment in our hospital. After the soft tissue damage repair, a large autologous iliac bone was used to reconstruct the lateral column of the tibial plateau.Results: All 18 patients were followed up over the course of 8-40 months, with an average of 23.44 months. All patients reported zero postoperative infection, skin and soft tissue necrosis, and loosening/breakage of the internal fixation. Regular postoperative review revealed that all patients achieved complete bony union, as evidenced by X-ray film, at 6 months after operation. Knee function (HSS) scores averaged 86.72 points at 1 year after operation; 15 people with 85 points or more, 2 people with 70-84 points, and one with 68 points. The excellent rate, according to HSS was 90%.Conclusions: Complex tibial plateau fractures with extensive soft tissue damage can be effectively remedied with a staged treatment, wherein a lateral column reconstruction is performed using a large iliac bone.

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Functional outcome of hybrid external fixator in proximal tibial fractures Schatzker type V and VI with Gustillo grade-II

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20214959 ◽

2021 ◽

Vol 8 (1) ◽

pp. 43

Author(s):

Johney Juneja ◽

Mohzin Asiger ◽

Dinesh Kumar ◽

Mahendra P. Jain ◽

Gaurav Garg ◽

...

Keyword(s):

Soft Tissue ◽

External Fixator ◽

Tibial Plateau ◽

High Energy ◽

Tibial Plateau Fractures ◽

Bony Union ◽

Fracture Stabilization ◽

Hybrid External Fixator ◽

Schatzker Type ◽

Type V

<h2>Background: Management of high energy tibial plateau fractures along with extensive soft tissue damage is still challenging to many orthopaedic surgeons. This study evaluates the purpose of hybrid external fixator intreating high energy tibial plateau fractures with minimal invasion and accurate reduction.</h2><h2>Methods: Twenty patients with high energy Schatzker type V and VI tibial plateau fractures with severe soft tissue injury were enrolled into the study in RNT medical college, Udaipur.</h2><h2>Results: The results- bony union, range of movements and associated complications were assessed. All fractures united in an average time period of 20 weeks. Ten patients developed knee stiffness, five patients developed delayed union andthreenon-union.15 patients required split skin graft. Final outcome showed excellent score in 53 patients.</h2><h2>Conclusions: Hybrid external fixation is a safe option for managing complex high energy tibial plateau fractures by simultaneously providing adequate fracture stabilization and necessary protection to soft tissue healing to achieve bony union.</h2>

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Does a staged treatment of high energy tibial plateau fractures affect functional results and bony union? A case series

Chinese Journal of Traumatology ◽

10.1016/j.cjtee.2020.03.002 ◽

2020 ◽

Vol 23 (4) ◽

pp. 238-242

Author(s):

Nilesh Barwar ◽

Abhay Elhence ◽

Sumit Banerjee ◽

Nitesh gahlot

Keyword(s):

Tibial Plateau ◽

Case Series ◽

Functional Results ◽

High Energy ◽

Tibial Plateau Fractures ◽

Bony Union ◽

Staged Treatment

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Small Wire External Fixation for High-Energy Tibial Plateau Fractures

Journal of Orthopaedic Surgery ◽

10.1177/230949900701500202 ◽

2007 ◽

Vol 15 (2) ◽

pp. 137-143 ◽

Cited By ~ 24

Author(s):

H Kataria ◽

N Sharma ◽

RK Kanojia

Keyword(s):

Soft Tissue ◽

External Fixation ◽

Tibial Plateau ◽

High Energy ◽

Tibial Plateau Fractures ◽

High Rate ◽

Anatomical Reconstruction ◽

Functional Score ◽

Soft Tissue Necrosis ◽

The Mean

Purpose. To assess results of small wire external fixation using a ligamentotaxis technique for high-energy tibial plateau fractures. Methods. Between April 2002 and May 2004, 38 consecutive patients aged 21 to 60 (mean, 32) years underwent small wire external fixation for high-energy tibial plateau fractures. 15 involved the right and 23 the left knee. 34 were closed and 4 were open injuries. Fractures were classified according to Schatzker's staging system. After a minimal of 2 years' follow-up (range, 24–42 months), each affected knee was evaluated using Rasmussen's (1) 30-point clinical grading system and (2) radiological evaluation. Results. There were 22 type-VI and 16 type-V Schatzker tibial plateau fractures. Complications consisted of: 2 superficial infections, 3 pin site infections, and 4 peroneal nerve palsies. No soft tissue necrosis or devitalisation occurred. The mean range of knee movement was 132°. The mean Rasmussen radiological score was 14 (range, 10–18): excellent in 6, good in 26, and fair in 6. The mean Rasmusssen functional score was 26 (range, 17–30): excellent in 19 patients, good in 17, and fair in 2. Clinical results did not parallel the radiological results. Conclusion. Small wire external fixation allows anatomical reconstruction of the articular surface, stable fixation of fracture fragments, early movement of the joint, and care of associated soft tissue injuries, without a high rate of complications.

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