scholarly journals Tibial plateau fractures in a limited-resource setting: A prospective study of surgical techniques and outcome over three years

2022 ◽  
pp. 31
Author(s):  
Keyword(s):  
External Fixation ◽  
Tibial Plateau ◽  
Wide Spectrum ◽  
Surgical Techniques ◽  
Tibial Plateau Fractures ◽  
Resource Setting ◽  
Schatzker Type ◽  
Satisfactory Outcome ◽  
Pathologic Fractures ◽  
Post Traumatic

Introduction: Tibial plateau fractures form a wide spectrum of injuries accounting for 1.2% of all fractures and a prevalence of 10 cases per 100,000 inhabitants. Methodology: A prospective consecutive multicentre study from May 2018 to May 2021 was carried out in Yaounde. All consenting cases of tibial plateau fracture underwent surgical treatment while patients with pathologic fractures, previous knee osteoarthritis, medically unfit for surgery, and discharging against medical advice were excluded. Data was analysed with SPSS 26.0 and the level of significance set at p<0.05. Results:Eighty-four (84) cases of tibial plateau fractures were sampled and 68 consented to surgery. The mean age was 42 ±13.6 years and sex ratio 2.4. Estimated prevalence was 2.2 cases per 100,000 inhabitants. Schatzker type II fractures were most represented (33.3%). The left leg was affected in 57.1%. Motorbike accidents were the main cause of injury (66.7%). Of the 68 operated, 63.3% by plating osteosynthesis, 32.4% by external fixation, and 4.4% by screws fixation. Tricortical iliac bone graft was realised in 4 cases. The minimum follow-up was 6 months, with a median of 18 months (5 to 37 months). Plating osteosynthesis (p<0.001), operative time between 60 to 120 minutes (p<0.02) and a good radiologic fracture healing (p<0.04) were associated with a satisfactory outcome. Poor prognosis was seen with open fractures (p<0.001), bridging external fixation (p<0.001), and Schatzker VI fractures (p<0.02). Complications included post-traumatic osteoarthritis (64.7%), post-traumatic osteomyelitis (29.4%), knee ankylosis (5.9%), and limb malalignment (30.9%). Conclusion:The prevalence of tibial plateau fractures remains lower than reported in literature but it is projected to rise. Plating remains a viable treatment option. A larger scale study will establish the burden of this entity in our context.

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

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.

scholarly journals Malreduction of tibial articular width in bicondylar tibial plateau fractures treated with circular external fixation is associated with post-traumatic osteoarthritis

2019 ◽  
Vol 16 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Shankar Thiagarajah ◽  
Graeme E. Hancock ◽  
Edward J. Mills ◽  
Jonathan C. McGregor-Riley ◽  
Simon L. Royston ◽  
...  
Keyword(s):  
External Fixation ◽  
Tibial Plateau ◽  
Tibial Plateau Fractures ◽  
Post Traumatic ◽  
Bicondylar Tibial Plateau

scholarly journals Arthroscopic Reduction and Percutaneous Osteosynthesis of Tibial Plateau Fractures

2019 ◽  
Vol 7 (5) ◽  
pp. 779-781
Author(s):  
Konstantin Mitev ◽  
Gorgi Zafiroski ◽  
Sasho Mladenovski ◽  
Ljupcho Nikolov
Keyword(s):  
Soft Tissue ◽  
Tibial Plateau ◽  
Surgical Techniques ◽  
High Energy ◽  
Tibial Plateau Fractures ◽  
Percutaneous Technique ◽  
Case Presentation ◽  
Schatzker Type ◽  
Tissue Damages

BACKGROUND: Tibial plateau fractures are complex lesions capable of causing severe consequences if not appropriately treated. They are often the result of high-energy trauma and, not rarely, are associated with significant soft-tissue and intra-articular injuries. Different therapeutic options can be managed in the treatment of these lesions. Minimally invasive surgery percutaneous technique-offers several advantages compared to other surgical techniques and allows, with less additional soft tissue damages, good reduction and stable fixation of the fracture. CASE PRESENTATION: In this study, we assessed the results of the combined arthroscopic and radioscopic assisted reduction and internal fixation of tibial plateau fractures in 7 patients with Schatzker type II and III. CONCLUSION: According to Hohl’s and Rasmussen’s grading system, all of the patients scored excellent and good results at 1 year follow up. We experienced no complications due to arthroscopy.

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.

scholarly journals Cost Variation in Temporizing External Fixation of Tibial Plateau Fractures

2019 ◽  
Vol 33 ◽  
pp. S5-S10
Author(s):  
Kevin R. Hayek ◽  
Harsh R. Parikh ◽  
Dylan L. McCreary ◽  
Jerald R. Westberg ◽  
Gudrun Mirick ◽  
...  
Keyword(s):  
External Fixation ◽  
Tibial Plateau ◽  
Tibial Plateau Fractures ◽  
Cost Variation
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