scholarly journals Augmentation by Rafting Screw on Fixation of the Lateral Tibial Plateau Fractures

Author(s):  
Osama El Sayed Ali Hegazy ◽  
Mohamed Abd El Hameid Romeih ◽  
Ashraf Atef Mahmoud ◽  
Nabil Omar Gharbo

Background: Tibial plateau fracture is considered one of the most common intra-articular fractures, especially lateral condyle fractures. The purpose of this study is to evaluate clinical, radiological, and functional outcomes of using subchondral periarticular rafting screw above a lateral plate without bone grafting or substitute for Schatzker type II and type III fractures. Methods: This prospective study was carried out on 43 patients above the age of 18, fit for surgery with closed tibial plateau fracture [lateral split depression (type II) and lateral depression (type III) according to Schatzker classification] time of trauma less than 14 days with no other skeletal injuries. All patients were followed up for at least six months. All patients were treated by open reduction and internal fixation (ORIF) and using subchondral periarticular screws as rafting construct to maintain articular surface and protect it from collapse. Analysis of clinical outcome was clinically based on Modified Rasmussen clinical scoring system and radiologically based on Rasmussen radiological knee scoring system. Results: In our study, 28 females and 15 males with a mean age of 49.5 years, mechanisms of trauma were road traffic accidents in 26 cases, and fall from height in 17 cases, 24 cases with Schatzker type II fracture, and 19 with type III. According to functional Rasmussen score, acceptable results were 93.1%, (76.8% excellent & 11.6% good) while non-acceptable results were 6.9%, (4.6% fair & 2.3% poor). According to radiological Rasmussen score, acceptable results were 83.7%, (65% excellent & 18.7% good) while non-acceptable results were 16.3%, (9.3% & 7%). No significant difference was found between the studied groups regarding sex, side affected, type of fracture, and type of trauma. The final outcome was significantly affected by age, medical history. Conclusions: Fixation using a subchondral periarticular rafting screws for lateral split-depression and lateral depression tibial plateau fractures without using bone graft or bone substitutes is a viable and good option during open reduction and internal fixation, helps surgeons achieve and preserve the anatomic joint line and normal mechanical axis, with superior functional results in the short term. Therefore, avoiding morbidity associated with bone grafting without compromising the fracture stability.

2019 ◽  
Vol 7 (7) ◽  
pp. 1133-1137 ◽  
Author(s):  
Sherif Hamdy Mohamed Zawam ◽  
Ahmed Mahmoud Gad

BACKGROUND: Tibial plateau fractures present an important entity in orthopaedic fractures. Arthroscopic-assisted reduction and internal fixation is a good alternative to ORIF as it has the advantage of direct visualisation of the articular surface of the plateau, direct assessment of the reduction of the articular surface, and managing any associated intra-articular pathology. AIM: Our study aim is to determine the results of arthroscopic assisted reduction and internal fixation of tibial plateau fractures. METHODS: This study involved 25 patients with tibial plateau fractures presenting to the emergency department of Cairo University Hospitals between the periods of November 2016 and May 2017. The patients were followed up for an average of 14 months (11-18 months). According to Schatzker’s classification, five patients had type I, eleven had type II, and nine patients had type III fractures. RESULTS: The average time to full union in Schatzker type I was 9.1 weeks, in type II was 10.2 weeks, and in type III it was 9.4. The mean clinical Rasmussen score among the 25 patients was 26 (range, 24-30). A group of 19 patients (76%) had excellent results, (4 type I, 8 types II, and 7 types III) 6 patients (24 %) had good results (1 type I, 3 types II, 2 types III). Radiologic results were excellent in (14 cases) 56.0% and good results (11 cases) 44%. CONCLUSION: Arthroscopic assisted reduction and fixation of tibial plateau fractures have the advantages of checking the adequacy of reduction, avoiding the need for detachment of the meniscus, and allowing for accurate diagnosis and management of associated knee injuries. Therefore, we recommend that arthroscopic assisted reduction and fixation of tibial plateau fractures should be used more often.


2019 ◽  
Vol 8 (6) ◽  
pp. e567-e574 ◽  
Author(s):  
Krzysztof Hermanowicz ◽  
Konrad Malinowski ◽  
Adrian Góralczyk ◽  
Tomasz Guszczyn ◽  
Robert F. LaPrade ◽  
...  

2014 ◽  
Vol 28 (2) ◽  
pp. 97-102 ◽  
Author(s):  
Marschall B. Berkes ◽  
Milton T.M. Little ◽  
Patrick C. Schottel ◽  
Nadine C. Pardee ◽  
Aernout Zuiderbaan ◽  
...  

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