scholarly journals Application of Percutaneous Screw Fixation and Closed Reduction for Tibial Plateau Fractures in Karachi, Pakistan

2021 ◽  
pp. 25-30
Author(s):  
Muhammad Azeem Akhund ◽  
Muhammad Latif ◽  
Rahat Zahoor Moton ◽  
Zohaib Khan ◽  
Zohaib Nawaz ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Tibial Plateau ◽  
Screw Fixation ◽  
Case Series ◽  
Early Mobilization ◽  
Tibial Plateau Fractures ◽  
Type I ◽  
Percutaneous Screw Fixation ◽  
Schatzker Classification ◽  
Average Patient

Objective: Objective of this study is to assess the application of percutaneous screw fixation and closed reduction for tibial plateau fractures in Karachi, Pakistan. Methods: The study design of this study is case series with sample size of 58 patients calculated by WHO calculator with functional outcome of 80-100%. The duration of the study was about 6 months.Non-probability sequential technique was adopted for data collection. Results: The average patient age was 35.35±6.84 years however male patient were high in numbers (83.8%). Types of fractures (type I, II and IV) and functional outcomes (un-satisfactory and satisfactory) showed 17(29.3%), 33(56.8%) and 12(20.6%) and 4(6.45%) and 58(93.5%). The mean Rasmussen Score was 24.6(4.9%) however significant relationship between age and functional group were observed (p<0.05). The Rasmussen Functional Scoring System and Schatzker classification were also evaluated w.r.t ache, capability of walking normally, extension lag, stability as well as range of motion. Scores ranging from 28 up till 36 stipulate excellent, from 20 to 27 good, considering score of 10 to 20 fair and 6 to 10 poor. Conclusion: The application of Percutaneous screw fixation and closed reduction for tibial plateau fractures in Karachi, Pakistanis less invasive, decrease hospital stays and charges, escalation of early mobilization along with satisfactory outcomes.

scholarly journals Closed Reduction and Percutaneous Screw Fixation for Tibial Plateau Fractures

2012 ◽  
Vol 20 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Radheshyam Sament ◽  
JC Mayanger ◽  
Sujit Kumar Tripathy ◽  
Ramesh Kumar Sen
Keyword(s):  
Closed Reduction ◽  
Tibial Plateau ◽  
Screw Fixation ◽  
Tibial Plateau Fractures ◽  
Percutaneous Screw Fixation

scholarly journals Canulated Screw Fixation for Tibial Plateau Fracture in Adults

2016 ◽  
Vol 22 (3) ◽  
Author(s):  
Faheem Ahmed Memon ◽  
Abbas Memon ◽  
Mehtab Pirwani
Keyword(s):  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Screw Fixation ◽  
Early Mobilization ◽  
Type I ◽  
Rigid Fixation ◽  
Percutaneous Screw Fixation ◽  
Severe Injuries ◽  
Schatzker Type ◽  
Plateau Fracture

<p><strong>Objective:</strong><strong>  </strong>To determine percutaneous screw fixation (PSF) as fair treatment option for Schatzker type I, closed tibial plateau fracture in adults.</p><p><strong>Patients and Methods:</strong><strong>  </strong>30 male and female adults between the ages of 20 and 40 were included. Only displaced Schatzkar type I closed tibial plateau fractures without any associated injury or complication were included. Type II, III, IV, V and VI, fractures with infection, patients with other severe injuries and neurovascular compromise fractures were excluded. Patients were followed weekly for one month, every alternate week for four months, thereafter monthly for up to six months to assess range of motion, deformity, union or any other complication.</p><p><strong>Results:</strong><strong>  </strong>Mean healing was 11.6 weeks. Mean hospital stay was 8.4 days. The overall clinical results were excellent in 20 (66.6%), good in 8 (26.6%), fair in 2 (6.6%) cases.<strong></strong></p><p><strong>Conclusion:</strong><strong>  </strong>Percutaneous screw fixation provided</p><p>better results in close displaced type I Schatzker tibial plateau fracture in adults. It is minimally invasive and achieved articular anatomical reduction, rigid fixation and early mobilization.</p>

Percutaneous screw fixation of tibial plateau fractures

Injury ◽  
1992 ◽  
Vol 23 (6) ◽  
pp. 387-389 ◽  
Author(s):  
P. Keogh ◽  
C. Kelly ◽  
W.F. Cashman ◽  
A.J. McGuinness ◽  
S.K. O'Rourke
Keyword(s):  
Tibial Plateau ◽  
Screw Fixation ◽  
Tibial Plateau Fractures ◽  
Percutaneous Screw Fixation

Indirect Reduction and Percutaneous Screw Fixation of Displaced Tibial Plateau Fractures

1992 ◽  
Vol 6 (3) ◽  
pp. 340-346 ◽  
Author(s):  
Kenneth J. Koval ◽  
Roy Sanders ◽  
Joseph Borrelli ◽  
David Helfet ◽  
Thomas DiPasquale ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Screw Fixation ◽  
Tibial Plateau Fractures ◽  
Indirect Reduction ◽  
Percutaneous Screw Fixation

scholarly journals Early Results of the Medial Approach for Arthroscopic-Assisted Fixation of Lateral Tibial Plateau Fractures

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0004
Author(s):  
Tunay Erden ◽  
Suat Batar ◽  
Gökçer Uzer ◽  
Demet Pepele Kurdal ◽  
Nurzat Elmalı
Keyword(s):  
Tibial Plateau ◽  
Soft Tissues ◽  
Lateral Meniscus ◽  
Case Series ◽  
Tibial Plateau Fractures ◽  
Meniscus Tear ◽  
Type I ◽  
Lateral Tibial Plateau ◽  
Schatzker Type ◽  
Diagnostic Arthroscopy

The use of arthroscopy in the management of tibial plateau fractures is not a particularly new concept. It has been used successfully for Schatzker types I–III fractures. In addition to evaluating the fracture itself, it is easier to evaluate the other intraarticular structures. Coventionally, reduction for lateral tibial plateau fractures have been performed through a laterally based metaphyseal window, which is not without limitations, including difficulty with reduction of the fracture, as well as bone grafting though the resultant short subchondral tunnel. Also, there is a risk of lateral vascular supply distrubtion because of same side fracture. A medially based metaphyseal window to approach lateral tibial plateau fractures allows for minimal insult to the soft tissues, with advantageous ease of reduction and grafting through a longer tunnel for subchondral support. We aimed to present our initial experiences in twelwe cases approaching lateral tibial plateau fractures through a medial metaphyseal window. Material-Methods: Our series involves 12 patients with 7 Schatzker type II, 3 Schatzker type I, and 2 Schatzker type III fractures. There were 8 males and 4 females. The average age at the time of surgery was 37 (25-57) years. All of the patients underwent plain radiography and BT in each knee Time from injury to surgery was 6.2 days. Follow up was 18 months (9-22 months).Firstly diagnostic arthroscopy was performed. Concomittant pathology was adreessed as needed. There was 3 lateral meniscus tear that treated with partial meniscectomy. An ACL guide pin was placed percutaneously anteromedial tibia approximately 9 cm distal to the joint line. Once stisfactory positioning a cortical window 1x2 cm. made around the guide pin. Reduction was accomplished with a bone tamp that fits easily into the tunnel. Screws were used as rafters to support the articular surface and subchondral bone. We used in 7 patients lateral plate and screws and in 5 patients only screws. Care was taken to keep pump pressure at approximately 40 millimeters of mercury for alleviate the risk of compartment syndrome. Results: No complications related to the procedure were observed. No secondary loss of reduction was observed in radiological controls. Functional assessment according to HSS of the patients were excellent in 5 cases, good in 5 cases and fair 2 cases. Discussion: Because depressed fragments are elevated from distal cortical windows, the importance of an intact, or easily restored, “cortical envelope” is paramount. This case series showed satisfactory early clinical results. [Figure: see text][Figure: see text]

scholarly journals Retrospective Evaluation of the Results of Arthroscopy Assisted Reduction and Osteosynthesis of Tibial Plateau Fractures and the Role of the Arthroscopy at Tibial Plateau Fractures

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0028
Author(s):  
Hasan Ozturk ◽  
Mahmut Tuzlu ◽  
Ahmet Savran ◽  
Bayram Kose
Keyword(s):  
Compartment Syndrome ◽  
Tibial Plateau ◽  
Plate Osteosynthesis ◽  
Case Series ◽  
Tibial Plateau Fractures ◽  
Joint Surface ◽  
Functional Score ◽  
Control Group ◽  
Schatzker Classification

Objectives: Aim of this study is to compare the medium and long term functional and radiological results of 31 patients with tibial plateau fractures, treated by same surgeon with arthroscopy assisted reduction and osteosynthesis between 2006 and 2013. Methods: This study is designed as evaluation of retrospective case series. 52 patients who has administered Tepecik Education and Research Hospital or Private Izmir Hospital between 2006 and 2013 with tibial plateau fracture and treated by same surgeon with arthroscopic assisted reduction and osteosynthesis is evaluated. Patients with insufficient data and cannot continue follow-up are excluded. 31 patient is included to study meeting our criteria. Injury mechanism, physical examination findings, operation records, concomitant intra articular pathologies, need for allograft or autograft and radiological investigations are retrospectively obtained from hospital medical record system. Preoperative evaluation depends on Schatzker Classification. Patients with floating knee, ipsilateral tibia diaphysis fracture, distal femoral intraarticular fracture, compartment syndrome or neurovascular injury is excluded from study. We didn’t take Schatzker Class is not an exclusion criteria. Results are investigated with Rasmussen radiological and clinical scores statistically. Results: 31 patients (23 male, 7 female) with mean age of 46,3 (min. 18- max. 67) is included our study with the mean follow-up of 45 months. Simultaneous meniscus lesion is detected in 15 patients and repair or partial meniscectomy is performed depending on the lesion. 10 patients need for allograft or autografting for joint surface restoration. Medial and/or lateral plate osteosynthesis is performed depending on fracture configuration. Final average Rasmussen functional score is calculated 25,7 and final average Rasmussen radiological score as 16,5. Secondary arthroscopic debridement is needed in 3 patients with arthrofibrosis. Conclusion: First arthroscopy assisted intra-articular fracture treatment is done in 1993 at knee joint and technique is improved with years. With the published satisfactory results of arthroscopy assisted series, current treatment of choice in tibial plateau fractures became arthroscopy assisted osteosynthesis, same as our routine application in our clinics. Advantages of arthroscopy is opportunity of treatment of concomitant intra articular pathologies, differentiation of these lesions as acute or degenerative and chronic more objective than any other imaging modality, detection of chondral injury more accurate and control of anatomical reduction of fracture lines. Downside of our study is lack of control group. Our conclusion is arthroscopy assistance in tibial plateau fractures improves results without increase in compartment syndrome or other complication rate when compared to literature.

scholarly journals Arthroscopic management of proximal tibial fractures: technical note and case series presentation

2015 ◽  
Vol 88 (2) ◽  
pp. 233-236 ◽  
Author(s):  
Horea Benea ◽  
Gheorghe Tomoaia ◽  
Artur Martin ◽  
Ciprian Bardas
Keyword(s):  
Internal Fixation ◽  
Tibial Plateau ◽  
Case Series ◽  
Tibial Plateau Fractures ◽  
Tibial Fractures ◽  
Type I ◽  
Arthroscopic Reduction ◽  
Schatzker Type ◽  
Associated Lesions ◽  
Proximal Tibial Fractures

Background and aims. The purpose of this article is to describe a new surgical method of arthroscopy assisted treatment of intraarticular proximal tibial fractures (ARIF – arthroscopic reduction and internal fixation), analyzing its efficiency and safety on a series of patients. Tibial plateau fractures affect the proximal tibial metaphyseal and articular surface, representing 1.2% of all fractures and up to 8% of all fractures in elderly. Patients and method. Our case series consists of 6 patients with Schatzker types I-III tibial plateau fractures, treated in the Orthopedic and Traumatology Clinic of Cluj-Napoca from July 2012 to August 2014. Patients included in the study presented Schatzker type I-III tibial plateau fracture.Results. The results obtained with the arthroscopic method were excellent in 5 cases (mean Rasmussen score 27.60 points) and good in 1 case (mean score 23.75). The radiological consolidation appeared after a mean of 12 weeks. No major complication was noted.Conclusions. Diagnosis and treatment of associated lesions, shortening of hospitalization length and postoperative rehabilitation, but also the lower rate of complications, can make arthroscopic reduction and internal fixation the method of choice for the operative treatment of selected Schatzker I-III types of proximal tibial fractures.

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.

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