A new anatomic locking plate for the treatment of posterolateral tibial plateau fractures

Jian, Zhen; Ao, Rongguang; Zhou, Jian; Jiang, Xinhua; Zhang, Dianying; Yu, Baoqing

doi:10.1186/s12891-018-2216-2

Cited by 9 publications

(5 citation statements)

References 11 publications

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“…Intra-articular fractures need proper anatomic reduction with rigid fixation for a painless bony union to occur. 12,13 The average time to union which was determined radiologically was about 4.4 months. 2 of our patients had delayed union taking 10 and 11 months respectively for union.…”

Section: Discussionmentioning

confidence: 99%

A prospective study of management of tibial plateau fractures by locking compression plate in adults

Gawali¹,

Nair²,

Sonkawade³

2021

Int J Res Orthop

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Background: Tibial plateau fractures are one of the most complex and disabling fractures of the knee. The tibial plateau is important in transmitting load through the knee. These fractures need a meticulous management protocol in order to minimize patient's disability in range of movement, stability and reducing the risk of documented complications. The aim of the present study is to study the outcome of tibial plateau fractures managed with a locked compression plate.Methods: This study was conducted at a tertiary-care medical college and hospital, Aurangabad specializing in post-graduate training, where all patients who underwent surgical treatment between September 2018 and October 2020 were included. Patients were assessed using the knee society score (KSS). These evaluations were done at 1, 3, 6, 9 and 12 months.Results: In our study we included 55 patients out of which we found union in 98% of patients with 83% of patients showing good flexion at knee joint (>110 degrees). 85% patients achieved union within 6 months. An excellent KSS grade was seen in 38.2% patients with another 43.6% showing good outcome. 4 patients showed infection and 1 showed non-union. A single case of malunion was seen in our study.Conclusions: Locked compression plates in tibial plateau fractures has revolutionized the way these fractures are managed. Anatomic reduction is of utmost importance. Early physiotherapy which plays key role in preventing knee stiffness, use of bone grafts and good fixation are important for successful outcome.

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Section: Discussionmentioning

confidence: 99%

A prospective study of management of tibial plateau fractures by locking compression plate in adults

Gawali¹,

Nair²,

Sonkawade³

2021

Int J Res Orthop

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“…In recent years, 3D printing technology has been widely used in the eld of orthopaedic trauma, and this technology can transform two-dimensional images into solid models [15].3D images allow for more accurate pre-operative planning, simulation of surgery, and other operations, leading to a complete and personalized surgical plan [16,17].By creating a 3D model, the surgeon has a clearer understanding of the patient's fracture, which provides a basis for the selection and placement of xation and increases the likelihood of fracture reduction [18].Xie and Shen compared 3D printing with incisional internal xation in the treatment of tibial plateau fractures, and showed that 3D printing shortened operative time and fracture site healing time, and reduced operative bleeding [19,20].Ren, Jian et al tested a common plate and a new anatomically locked plate by 3D printing technology, respectively, and the newly designed xation material is stable and reliable, and more suitable for clinical application [21,22].However, there are no reports on the use of 3D printed fracture external repositioning models with preoperative placement of rigid markers.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Placement of Rigid Markers for the Treatment of Tibial Fractures Using 3D Printed External Repositioning Model Combined With External Fixator

Zhao

Zhang

et al. 2021

Preprint

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Purpose: To investigate the effectiveness of preoperative placement of a rigid marker 3D printed external repositioning model combined with an external fixation frame in patients with tibial fractures.Methods: Fifty-five patients with tibial fractures treated from June 2019 to August 2020 were used as study subjects. Patients were divided into a control group and an observation group according to the order of their admission to the hospital. Patients in the control group were treated with conventional surgery, and patients in the observation group were treated with preoperative placement of rigid markers 3D printed external repositioning models combined with external fixators. The treatment results of the two groups were compared.Results: Patients in the observation group had significantly shorter operative time, hospital stay and fracture healing time than patients in the control group, and intraoperative bleeding was significantly less than that in the control group (P<0.05). The pain level decreased in both groups as the time lengthened after surgery. At the same time point, the degree of pain in the observation group was significantly lower than that in the control group (P<0.05). The incidence of postoperative complications was 6.66% in the observation group and 36% in the control group, and the incidence of postoperative complications was significantly lower in the observation group than in the control group (P<0.05). The excellent rate of fracture healing was 60% in the observation group and 86.67% in the control group, and the difference in the excellent rate of fracture healing between the two groups was significant (P<0.05). Patients in both groups gradually recovered their knee and ankle functions after surgery with the extension of time. At the same time point, the HSS and Maryland scores of patients in the observation group were significantly higher than those in the control group (P<0.05).Conclusion：By using preoperative placement of rigid markers 3D printed external repositioning model combined with external fixator treatment. No further incision or fluoroscopic closed reduction is required. This reduces the patient's pain and improves the patient's fracture healing results.

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“…The wide proximal part can achieve excellent wrapping of the posteromedial condyle. Four proximal row screws paralleled with the plateau could buttress powerfully, having a “raft effect,” 26 which provides firm strength holding the articular surface. Not only an effective buttress can be achieved, but also compression fixation of large fragments.…”

Section: Discussionmentioning

confidence: 99%

Modified Anatomic Locking Plate for the Treatment of Posteromedial Tibial Plateau Fractures

Jian

Zhou

et al. 2020

Orthopaedic Surgery

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Objective: To evaluate the safety and clinical efficacy of a modified anatomic locking plate for the treatment of posteromedial tibial plateau fractures. Methods: A retrospective study was performed in our department. Between January 2014 and February 2017, 11 patients with posteromedial tibial plateau fractures underwent surgery with the new anatomic locking plate for the posteromedial tibial plateau via the posteromedial approach. The study included 7 male and 4 female patients, with a mean age at the time of the operation of 39 years. During surgery, operation time and blood loss were recorded. Clinical evaluation was performed using the Tegner-Lysholm functional score, the Rasmussen functional score, and the Rasmussen anatomical score. Results: The mean follow-up time of the study was 35 months. The mean interval between the time of injury and the surgery was 7.4 days. Radiological fracture union was evident in all patients at 14 weeks. During surgery, the blood loss ranged from 50 to 150 mL, and the duration ranged from 55 to 90 min. The Tegner-Lysholm functional score ranged from 80 to 96 at the final follow up. Moreover, the final Rasmussen functional score ranged from 25 to 28, and the Rasmussen anatomical score ranged from 15 to 18. The mean knee arc of motion was 137 (range, 122-153). Symptoms of knee instability or severe pain were not found in any cases. No flexion contractures or extensor lag was seen. No infection, deep vein thrombosis, or graft site morbidity was seen at the follow up. No case of reduction loss or internal fixation failure was reported during the follow-up. Conclusion: With the clinical data of the small-sample-size population (11 patients) during a 19 to 60-month followup, the modified anatomic locking plate for the posteromedial tibial plateau proved to be safe and effective and is an adequate fixation method for the treatment of posteromedial tibial plateau fractures.

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A new anatomic locking plate for the treatment of posterolateral tibial plateau fractures

Cited by 9 publications

References 11 publications

A prospective study of management of tibial plateau fractures by locking compression plate in adults

A prospective study of management of tibial plateau fractures by locking compression plate in adults

Preoperative Placement of Rigid Markers for the Treatment of Tibial Fractures Using 3D Printed External Repositioning Model Combined With External Fixator

Modified Anatomic Locking Plate for the Treatment of Posteromedial Tibial Plateau Fractures

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