A novel arthroscopically assisted reduction technique for three patterns of posterolateral tibial plateau fractures

Yang, Yang; Zhou, Xiaoxiao; Ji, Houlin; Zhou, Xiao‐Bo; Ye, Linchao; Zhang, Mengqin

doi:10.1186/s13018-020-01901-5

Cited by 10 publications

(13 citation statements)

References 30 publications

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“…In addition, free subchondral locking screws combined with VA-LCP tend to strengthen structural properties in reconstructing lateral tibial plateau fractures[ 31 ]. Our arthroscopically assisted reduction and fixation with screws also satisfied both clinical and radiological outcomes [ 32 ].…”

Section: Discussionmentioning

confidence: 90%

The treatment of posterolateral tibial plateau fracture with a newly designed anatomical plate via the trans-supra-fibular head approach: preliminary outcomes

Cai

Yuan

et al. 2021

BMC Musculoskelet Disord

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Background There are no ideal plates or approaches for anatomical restoration and rigid fixation of posterolateral tibial plateau fractures. This study aimed to evaluate the short-term preliminary outcomes of our novel anatomical plate placed via the trans-supra-fibular approach to treat posterolateral tibial plateau fractures. Methods From May 2016 to May 2018, 23 consecutive patients with posterolateral tibial quadrant fractures underwent open reduction with internal fixation via the trans-supra-fibular-head approach with our newly developed plate. The tibial plateau-tibial shaft angle (TPTSA), lateral posterior tibial slope angle (LPSTA), step-off, and condylar widening were measured on radiological images pre-operatively, 3 days post-operatively, 3 months post-operatively, and at the final follow-up examination. The radiological Rasmussen score was calculated, and the Hospital for Special Surgery (HSS) knee score was assessed to evaluate the functional outcomes. Results The LTPSA, TPTSA, step-off, and condylar widening at 3 days post-operatively, 3 months post-operatively, and at the final follow-up were significantly different (p = 0.001) compared with those pre-operatively, as was the radiological Rasmussen score (p = 0.001). The HSS score at the final follow-up was 89.10 ± 5.94 (range, 78–98), which was significantly higher than that at the 3-month follow-up 84.36 ± 6.76 (range, 74–96); p = 0.001). Conclusions Our newly designed anatomical plate placed via the trans-supra-fibular approach can effectively treat posterolateral tibial plateau fractures. We noted minor trauma, stable fixation, and satisfactory clinical results.

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Section: Discussionmentioning

confidence: 90%

The treatment of posterolateral tibial plateau fracture with a newly designed anatomical plate via the trans-supra-fibular head approach: preliminary outcomes

Cai

Yuan

et al. 2021

BMC Musculoskelet Disord

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“…The posterolateral (PL) tibial plateau fracture can occur alone or in combination with injuries to anterolateral, posteromedial, or anteromedial quadrants in high-energy fractures, even be associated with anterior cruciate ligament (ACL) incompetence, such as tibial eminence fractures [12,13]. Most commonly caused by combined eversion and axial force in a flexed or semi-flexed knee position, the isolated PL quadrant tibial plateau fracture is often due to low energy violence such as widely used electric vehicles [12].…”

Section: Discussionmentioning

confidence: 99%

Surgical exposure to posterolateral quadrant tibial plateau fractures: an anatomic comparison of posterolateral and posteromedial approaches

Chang

et al. 2022

J Orthop Surg Res

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Background Management of posterolateral tibial plateau quadrant fractures can be challenging, and two posterior approaches were frequently used for exposure, reduction, and fixation: posterolateral approach and posteromedial approach. The purpose of this study was to compare their deep anatomical structure and analyze their limits and the risk of injury to important structures during surgical dissection of two approaches. Method Five lower limb specimens were used in this study. After dissection of the skin and superficial fascia of each specimen, deep structures were dissected via posteromedial and posterolateral approach, and several parameters including perpendicular distance from the anterior tibial artery coursing through the interosseous membrane fissure to the lateral joint line and apex of fibular head and so on were measured and analyzed. Result The perpendicular distance from the ATA coursing through the interosseous membrane fissure to the lateral joint line was 49.3 ± 5.6 mm (range 41.3–56.7 mm), while the distance to the apex of fibular head was 37.7 ± 7.2 mm (range 29.0–48.0 mm). The transverse distance of the anterior tibial vascular bundle is around 10 mm. The perpendicular distance from the top accompanying vein of the ATA bundle to lateral joint line and apex of fibular head was 44.1 ± 6.3 mm and 32.5 ± 7.6 mm, respectively. The maximum proportion of posterolateral tibial plateau shielded by the fibular head from the posterior view was 61.7 ± 4.9% (range 55.6–64.1%). The average length of popliteus muscle outside the joint was 83.1 ± 6.0 mm (range 76.5–92.2 mm), and the width in the middle was 28.1 ± 4.3 mm (range 26.6–29.1 mm). Conclusion Although posterolateral approach seems more direct for exposure of posterolateral quadrant tibial plateau fracture, it has three major disadvantages in deep dissection. Posteromedial approach through the medial board of medial head of gastrocnemius–soleus may be safer, but it was hard for direct visualization of articular surface which limits it usage for only a few cases.

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“…Regular check-ups radiological evaluations and functional outcomes were determined by Rasmussen clinicalfunctional assessment score. Scores were graded as Excellent (27-30), Good (20)(21)(22)(23)(24)(25)(26), Fair (10)(11)(12)(13)(14)(15)(16)(17)(18)(19), and Poor (<10). 13 Any incidence of infection was reported and compared.…”

Section: Methodsmentioning

confidence: 99%

“…12 Studies evaluating Rasmussen's knee functional outcome demonstrate varying results with the hybrid Ilizarov technique and locking plate approach. 13,14 This research aims to contribute to the existing knowledge by comparing the functional outcomes of patients undergoing the locking plate approach versus the hybrid Ilizarov technique for complicated tibial plateau fractures. Given the scarcity of local studies on this issue, the findings of this research are anticipated to enhance the understanding and treatment of such fractures in the future.…”

Section: Introductionmentioning

confidence: 99%

Comparison of functional outcome of locking plate technique versus hybrid Ilizarov technique for complicated tibial plateau fractures

jafree,

hamid,

Uddin

et al. 2024

BioMedica

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This study compares the functional outcomes of two approaches, the locking plate technique and the hybrid Ilizarov technique, in managing complicated tibial plateau fractures. Enrolling 78 patients at Jinnah Hospital, the research explores a nuanced difference in results. In Group A (Hybrid Ilizarov Technique), 84.6% males and 15.4% females participated, while Group B (Locking Plate Technique) had 82.1% males and 17.9% females. The locking plate approach demonstrated superior outcomes, suggesting its efficacy in treating tibial plateau fractures.  Study design: Cross sectional study. Study setting was department of Orthopedic Surgery, Jinnah Hospital Lahore Objective/purpose of the study was to evaluate the functional results of locking plate and hybrid Ilizarov procedure for tibial plateau fractures using Rasmussen's knee functional score.

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A novel arthroscopically assisted reduction technique for three patterns of posterolateral tibial plateau fractures

Cited by 10 publications

References 30 publications

The treatment of posterolateral tibial plateau fracture with a newly designed anatomical plate via the trans-supra-fibular head approach: preliminary outcomes

The treatment of posterolateral tibial plateau fracture with a newly designed anatomical plate via the trans-supra-fibular head approach: preliminary outcomes

Surgical exposure to posterolateral quadrant tibial plateau fractures: an anatomic comparison of posterolateral and posteromedial approaches

Comparison of functional outcome of locking plate technique versus hybrid Ilizarov technique for complicated tibial plateau fractures

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