A PROSPECTIVE STUDY EVALUATING ASSOCIATION BETWEEN TIBIAL PLATEAU FRACTURE MORPHOLOGY WITH LIGAMENT AND MENISCAL INJURY AROUND KNEE.

2021 ◽  
pp. 33-35
Author(s):  
Manoj Kumar ◽  
Bharat Bhushan ◽  
Arun Vaishy ◽  
Rajendra Fageria ◽  
Ramakishan Ramakishan
Keyword(s):  
Soft Tissue ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Soft Tissue Injuries ◽  
Fracture Morphology ◽  
Tibial Plateau Fractures ◽  
Meniscal Injury ◽  
Classi Cation ◽  
Plateau Fracture ◽  
A Prospective Study

INTRODUCTION: In the modern world,due to advent of high speed motor vehicles , high energy trauma commonly involves the knee joint and results in complex tibial plateau fractures and associated ligament and meniscal injuries . Proper diagnosis and management of these injuries reduced the chances of degenerative changes around knee joint later on. MATERIAL AND METHOD: A prospective study was conducted in the Department of Orthopaedics in a tertiary health care center of western rajasthan from January 2018 to December 2020 . A total of eighty patients( 62 males: 18 females) with tibial plateau fractures and associated soft tissue injuries were included .Patients were assessed both clinically and radiologically and “ SCHATZKER'S classication was used to classify the tibial plateau fractures. Pre-operatively in every case CT-scan was used to study fracture pattern and MRI was done to see fracture morphology and associated soft tissue injuries. RESULT: A total 80 patient was included in our study,out of which 73 (91.25%) having ligaments( Cruciate and Collaterals) and meniscal injury . Injury to the lateral meniscus was found most frequently in Schatzker II fracture (p<0.0006) and medial meniscus in schatzker IV (p< 0.011). Variable association was shown by ACL and PCL injuries with tibial plateu fracture morphology ,but as the grade of designation increases within schatzker classication as does the frequency of cruciate ligament tear. Overall incidence of LCL rupture occurred least frequently in Schatzker II fractures (7 of 34; 20.5%), which was statistically signicant (P < 0.01). Complete MCL tear occurred in 27( 33.7%) of all fractures and in 41% of Schatzker II fractures. PLC tear had shown signicant association with medial tibial plateu fracture (schatzker IV). CONCLUSION: The likelihood of the cruciate , collateral ligament and PLC injury increases as the grade of designation within schatzker classication (schatzker I-VI). PLC injury had a signicant association with medial tibial plateu fracture (schatzker IV) and MCL had a signicant association with lateral tibial plateau fracture .

The degree of articular depression as a predictor of soft-tissue injuries in tibial plateau fracture

2012 ◽  
Vol 21 (3) ◽  
pp. 564-570 ◽  
Author(s):  
Alexander S. Spiro ◽  
Marc Regier ◽  
Alexander Novo de Oliveira ◽  
Eik Vettorazzi ◽  
Michael Hoffmann ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Soft Tissue Injuries ◽  
Plateau Fracture ◽  
Tissue Injuries

The Effect of Soft Tissue Injuries on Clinical Outcomes After Tibial Plateau Fracture Fixation

2018 ◽  
Vol 32 (3) ◽  
pp. 141-147 ◽  
Author(s):  
Stephen J. Warner ◽  
Matthew R. Garner ◽  
Patrick C. Schottel ◽  
Peter D. Fabricant ◽  
Ryan R. Thacher ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Clinical Outcomes ◽  
Fracture Fixation ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Soft Tissue Injuries ◽  
Plateau Fracture ◽  
Tissue Injuries

MR Imaging of Tibial Plateau Fractures: Evaluation of Fracture Types and Associated Soft Tissue Injuries

1997 ◽  
Vol 36 (5) ◽  
pp. 867
Author(s):  
Geon Lee ◽  
Chan Heo ◽  
Yong Jo Kim ◽  
Hyeok Po Kwon ◽  
Jung Hyeok Kwon ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Mr Imaging ◽  
Tibial Plateau ◽  
Soft Tissue Injuries ◽  
Tibial Plateau Fractures ◽  
Tissue Injuries ◽  
Fracture Types

Frequency and Fracture Morphology of the Posteromedial Fragment in Bicondylar Tibial Plateau Fracture Patterns

2008 ◽  
Vol 22 (3) ◽  
pp. 176-182 ◽  
Author(s):  
David P Barei ◽  
Timothy J OʼMara ◽  
Lisa A Taitsman ◽  
Robert P Dunbar ◽  
Sean E Nork
Keyword(s):  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Fracture Morphology ◽  
Fracture Patterns ◽  
Plateau Fracture ◽  
Bicondylar Tibial Plateau

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.

Mapping recovery in simple and complex tibial plateau fracture fixation

2019 ◽  
Vol 101-B (8) ◽  
pp. 1009-1014 ◽  
Author(s):  
D. N. Ramoutar ◽  
K. Lefaivre ◽  
H. Broekhuyse ◽  
P. Guy ◽  
P. O’Brien
Keyword(s):  
Functional Outcome ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Short Form ◽  
Tibial Plateau Fractures ◽  
Functional Score ◽  
Complex Group ◽  
Sf 36 ◽  
Functional Scores ◽  
Plateau Fracture

Aims The aim of this study was to determine the trajectory of recovery following fixation of tibial plateau fractures up to five-year follow-up, including simple (Schatzker I-IV) versus complex (Schatzker V-VI) fractures. Patients and Methods Patients undergoing open reduction and internal fixation (ORIF) for tibial plateau fractures were enrolled into a prospective database. Functional outcome, using the 36-Item Short Form Health Survey Physical Component Summary (SF-36 PCS), was collected at baseline, six months, one year, and five years. The trajectory of recovery for complex fractures (Schatzker V and VI) was compared with simple fractures (Schatzker I to IV). Minimal clinically important difference (MCID) was calculated between timepoints. In all, 182 patients were enrolled: 136 (74.7%) in simple and 46 (25.3%) in complex. There were 103 female patients and 79 male patients with a mean age of 45.8 years (15 to 86). Results Mean SF-36 PCS improved significantly in both groups from six to 12 months (p < 0.001) and one to five years (simple, p = 0.008; complex, p = 0.007). In both groups, the baseline scores were not reached at five years. The SF-36 PCS was significantly higher in the simple group compared with the complex group at both six months (p = 0.007) and 12 months (p = 0.01), but not at five years (p = 0.17). Between each timepoint, approximately 50% or more of the patients in each group achieved an MCID in their score change, indicating a significant clinical change in condition. The complex group had a much larger drop off in the first six months, with comparable proportions achieving MCID at the subsequent time intervals. Conclusion Tibial plateau fracture recovery was characterized overall by an initial decline in functional outcome from baseline, followed by a steep improvement from six to 12 months, and ongoing recovery up to five years. In simple patterns, patients tended to achieve a higher functional score by six months compared with the complex patterns. However, comparable functional scores between the groups achieved only at the five-year point suggest later recovery in the complex group. Function does not improve to baseline by five years in either group. This information is useful in counselling patients about the course of prospective recovery. Cite this article: Bone Joint J 2019;101-B:1009–1014.

Prediction of Soft-Tissue Injuries in Schatzker II Tibial Plateau Fractures based on Measurements of Plain Radiographs

2006 ◽  
Vol 60 (2) ◽  
pp. 319-324 ◽  
Author(s):  
Michael J. Gardner ◽  
Shahan Yacoubian ◽  
David Geller ◽  
Matthew Pode ◽  
Douglas Mintz ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Tibial Plateau ◽  
Soft Tissue Injuries ◽  
Tibial Plateau Fractures ◽  
Plain Radiographs ◽  
Tissue Injuries

scholarly journals FIXATION OF POSTERIOR TIBIAL PLATEAU FRACTURE AND ITS OUTCOME: A COMPARATIVE STUDY

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Hrishikesh Saodekar ◽  
Kamal Agrawal
Keyword(s):  
Functional Outcome ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Plate Fixation ◽  
Tibial Plateau Fractures ◽  
Fracture Union ◽  
Posterior Tibial ◽  
Plateau Fracture ◽  
Group A ◽  
Group B

Introduction: Tibial plateau fractures are complex injuries of proximal tibia which are produced by high- or low-energy trauma and principally affect young adult population. These fractures usually have associated soft-tissue lesions affecting the treatment. Posterior tibial plateau fractures (PTPF), may be medial or lateral, are common and they occur in about 28.8% patients as a part of bicondylar tibial plateau fractures. These fractures are difficult to reduce, therefore articular incongruity was not found to be detrimental factor in final functional outcomes. Studies have supported the fact that residual articular incongruence is well tolerated by proximal tibial plateau fracture in the form of minimal functional limitation or onset of arthrosis.  Anterolateral and anteromedial surgical approaches do not show adequate reduction and fixation of posterolateral and posteromedial fragments. To achieve this, it is advised to reduce and fix the fracture through specific posterolateral or posteromedial approaches that allow optimal reduction and plate/screw placement. Material and Methods: This comparative prospective cohort study on done on 50 adult patients. Two groups were formed: Group A – double-plate fixation with both posterior and anterolateral  having 25 participants and Group B – single anterolateral plate fixation having 25 participants in PTPFs were followed up to 1 year. For Group A, the reduction was done under direct vision and assisted with fluoroscopy in two planes. The reduction was assessed with submeniscal approach. In Group B posterior fragment was reduced by screws through the anterolateral plate followed by CT scan. Patients were evaluated by radiographs every 6 weeks till fracture union is evident. Fracture union was assessed by cortical continuity and progressive loss of fracture line on X-rays. Functional status at 1-year postoperative CT scanogram was done at final follow up to record articular subsidence, nonunion, coronal, or sagittal deformities. Knee functions were assessed by the International Knee Documentation Committee 2000 subjective knee evaluation form and objective functional Knee Society Score (KSS). Results: There were 22 male and 3 female in Group A while in Group B there were 20 male and 5 female. Right tibial fracture was observed in 15 cases and left in 10 cases in group A while in Group B right fracture was seen in 17 cases and in 8 cases left sided fracture. 23 cases each in group A and B were associated with RTA. Operative time (minutes) in group A and group B was 124 ± 26.7 and 79.52± 16.22 respectively. Total mean hospitalization days were 9.4±2.6 in group A and 8.2±1.5 in group B. Union time in group A was 14.6±3.4 weeks while in group B was 15.4±3.2. Statistically significant correlation was observed in group A and B with respect to KSS clinical outcome and KSS functional outcome. Flexion deformity was observed in 3 (12%) cases in group A and in 6 (24%) cases in group B. Conclusion:  PTPF can achieve an early and satisfactory functional outcome. Rehabilitation and fracture healing are better in PTPF. Keywords: Tibial plateau fractures, PTPF, Open reduction and internal fixation (ORIF)

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