scholarly journals Functional and Radiological Outcome of Schatzker type V and VI Tibial Plateau Fracture Treatment with Dual Plates with Minimum 3 years follow-up: A Prospective Study

Author(s):  
Neil Rohra
Author(s):  
Tutika Dinesh Kumar ◽  
Deepak Chamalla ◽  
Santhosh Babu Miryabbelli ◽  
M. Sai Ashok

<p class="abstract"><strong>Background:</strong> Tibial condyles with their articular surface forms major part of the knee joint, plays an important role in weight transmission and mobility. The proximal tibia fractures account for 1% of all the fractures. If these high velocity intra/peri articular fractures are not treated properly there will be high degree incidences of malunion, non-union, peri-op infections vs collapse of the medial condyle, ligamentous instability, malalignment of the axis, articular incongruity leading to post traumatic arthritis. Aim was to assess the anatomical reduction of articular surface of upper end of tibia and knee joint perfectly by operative treatment with internal fixation.  </p><p class="abstract"><strong>Methods:</strong> The study was done for a period of 1 years on 30 patients with bicondylar tibial plateau fractures diagnosed with Schatzker type V and VI. Age ranged from 20-60 years with majority being in 30-39 years range with a largely male preponderance. Patients were followed up to 12 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> Our study reported Honkonen Jarvinen clinical outcome to be 86% excellent, 11.7% good and 1.7% fair. The functional outcome was 81% excellent, 13% good, 5% fair and 1% poor. The Radiological outcome showed 79.2% excellent, 12% good, 0.70% fair results. Our study used Honkonen Jarvinen criteria for radiological, functional, clinical outcome which showed excellent to good result.  </p><p class="abstract"><strong>Conclusions:</strong> Dual plating is ideal for all bicondylar Tibial plateau fracture of Schatzker type V and VI with appropriate timing of surgery and understanding the anatomy, LCP system, appropriate technique with dual incision, the complication can be minimized, giving excellent to good results.  </p>


2020 ◽  
Author(s):  
Yilun Yao ◽  
Xiaoshu Wu ◽  
Lei Wu ◽  
Lei Yang ◽  
Chunzhi Jiang ◽  
...  

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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