Complications after tibia plateau fracture surgery

Papagelopoulos, Panayiotis J.; Partsinevelos, Antonios A.; Themistocleous, George S.; Mavrogenis, Andreas F.; Korres, Demetrios S.; Soucacos, Panayotis N.

doi:10.1016/j.injury.2005.06.035

Cited by 246 publications

(206 citation statements)

References 34 publications

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“…The incidence of secondary posttraumatic arthritis reportedly ranges from 26% to 74%, depending on injury severity, articular surface reduction, and the status of the meniscus [11,17,22]. Many of these patients are young with high functional demands yet present with severe PN receives research funding and royalties from Tornier, Inc (Grenoble, France).…”

Section: Introductionmentioning

confidence: 99%

Lateral Unicompartmental Knee Arthroplasty Relieves Pain and Improves Function in Posttraumatic Osteoarthritis

Lustig

Parratte

Magnussen

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Posttraumatic arthritis secondary to lateral tibial plateau fracture malunion causes pain and limited function for patients. It is sometimes technically challenging to correct malalignment in these patients with advanced arthritis using osteotomies. Lateral unicompartmental knee arthroplasty (UKA) may be an option to treat such patients. Questions/purposes We asked whether UKA for lateral posttraumatic osteoarthritis (1) reliably alleviates pain and improve function, (2) restores lower limb alignment, and (3) is as durable as UKA for primary lateral osteoarthritis. Patients and Methods We retrospectively reviewed 13 patients with lateral cemented UKA (mean age at surgery, 50.1 years) treated at two institutions between 1985 and 2007. We obtained Knee Society scores and evaluated radiographs for evidence of implant loosening or progression of arthritis in the medial compartment. Minimum followup was 3 years (mean, 10.2 years; range, 3-22.1 years). Results Mean Knee Society knee score improved from 51 points (range, 29-75 points) preoperatively to 88 points (range, 65-100 points) at last followup, suggesting the procedure relieved pain. Mean function score improved from 51 points (range, 10-89 points) preoperatively to 87 points (range, 35-100 points) at last followup. The mean hip-knee-ankle angle was 188°preoperatively (range, 184°-1938) and 185°(range, 183°-188°) at last followup. Prosthesis survivorship was 100% at 5 and 10 years and 80% at 15 years.

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Section: Introductionmentioning

confidence: 99%

Lateral Unicompartmental Knee Arthroplasty Relieves Pain and Improves Function in Posttraumatic Osteoarthritis

Lustig

Parratte

Magnussen

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…During operation direct reduction requires periosteal stripping and stable internal fixation necessitates considerable dissection, thereby sacrificing the vascular supply. These techniques are associated with high rates of complication, non-union, the frequent requirement for secondary bone grafts and loss of reduction being of particular concern [10] . Most investigators would agree that four primary factors can ultimately determine the prognosis of proximal plateau injuries: 1.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2017

Int. J. Orthop. Sci.

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Introduction: Fractures of the proximal tibia, particularly those that extend into the knee joint are termed as tibial plateau or tibial condylar fractures. It results from indirect coronal or direct axial compressive forces. Overall worldwide, it comprises of 1% of all fractures & 8% of the fractures in elderly. In the past two decades, with improvements in surgical techniques and implants, there has been a growing trend towards surgical management of these injuries. Thus we have advanced from the conservative approach to internal fixation in fractures as an acceptable mode of treatment. No proven uniform successful method of treatment. Nevertheless, tibial plateau fractures remain challenging because of their number, variety and complexity. Aim: To study the surgical management in terms of unilateral and dual plating for bicondylar intraarticular fractures of proximal tibia to obtain a stable, pain free, mobile joint, to prevent the development of osteoarthritis and to correlate the radiological findings with the type of fracture and the functional end result. Materials and Methods: This was a prospective study of 44 cases. All patients included in this study sustained tibial plateau fracture grade V and VI according to Schatzker Classification. We used Rasmussen's functional and radiological scoring system for the comparison of outcome of plating. In the surgical group 20 patients were treated by unilateral plating and 24 patients were with dual plating. These patients were followed up for an average period of 13 months. Results and discussion: In our study according to Rasmussens functional scoring 4 , we have achieved excellent outcome in 43%, good in 50%, fair in 7%, which is comparable to the standard studies. These studies suggest that while isolated lateral locked plating may offer a more biological approach to bicondylar fractures, and may provide a viable alternative for open fractures with a medial wound or fractures with tenous soft tissues, classical dual plating remains the most rigid construct. Conclusion: The surgical management of tibial bicoondylar fracture is challenging and dual plating gives excellent anatomical reduction and rigid fixation to restore articular congruity, facilitate early knee motion by reducing post-traumatic osteoarthritis and thus achieving optimal knee function.

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“…Moreover, the management of high energy proximal tibia fractures is a challenging task for the surgeon, as they are often associated with a number of complications. 3,[11][12][13] Of late with the better understanding of peculiarities in proximal tibial fracture, fracture healing, and complications associated with them, there has been research in better tissue friendly approaches (MIPPO) and development of better technically mature implant systems (LCP) for fracture fixation, which are showing promising results by early restoration of strength at fracture site and function of knee joint.…”

Section: Discussionmentioning

confidence: 99%

Outcome of treatment of proximal tibial plateau fractures by minimally invasive percutaneous plating osteosynthesis technique

et al. 2016

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Background: Fractures of the proximal tibia are accompanied by a wide range of severity which may include stable undisplaced fractures with minimal soft tissue injury to highly comminuted unstable fractures, and severe soft tissue involvement. With the better understanding of fracture healing biology and biomechanics of fracture fixation and healing, the trend of treatment is towards biological fixation, which can be accomplished by Minimally Invasive Percutaneous Plating Osteosynthesis (MIPPO) technique.Methods: Demographic data of patients were recorded on admission and thorough history and clinical examination was done. The fractures were assessed for soft tissue injuries and followed by radiological assessment of fracture with schatzkers classification. The surgeries included anterolateral and anteromedial approaches for all patients with ‘inverted hockey stick incision’ and were treated with MIPPO. They were regularly followed up at 6-8 weeks interval till complete fracture union. A clinical and radiological evaluation was carried out using the modified Rasmussen clinical and radiological criteria.Results: Out of the 20 patients treated, most of them were males and belonged to the age group of 20-40 years (75%). Unilateral fractures were more common than bilateral fractures and were of the type 4 and type 5 of Schatzkers classification which was usually associated with high velocity RTA. One patient each had infection, varus deformity and knee joint stiffness. 10 fractures gave excellent result, 7 fractures healed with good results. Only 2 of the patients showed fair results and 1 had poor result. Conclusions: All the fractures treated with MIPPO technique was found to be rapidly healing by secondary fracture union and hence achieving strong bone union across the fracture site due to inherent benefits of less tissue damage and minimal disturbance of fracture site biology.

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Complications after tibia plateau fracture surgery

Cited by 246 publications

References 34 publications

Lateral Unicompartmental Knee Arthroplasty Relieves Pain and Improves Function in Posttraumatic Osteoarthritis

Lateral Unicompartmental Knee Arthroplasty Relieves Pain and Improves Function in Posttraumatic Osteoarthritis

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Outcome of treatment of proximal tibial plateau fractures by minimally invasive percutaneous plating osteosynthesis technique

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