Dual locked plating of unstable bicondylar tibial plateau fractures

Özkaya, Ufuk; Parmaksizoglu, Atilla Sancar

doi:10.1016/j.injury.2015.05.025

Cited by 30 publications

(25 citation statements)

References 30 publications

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“… 5 , 6 The advent of minimally invasive techniques of internal fixation could not solve this challenge completely. 7 …”

Section: Introductionmentioning

confidence: 99%

“…Nonoperative management yields poor results and internal fixation has its own complications like wound break-down, skin necrosis, deep infections, stiffness and ankylosis depending on the extent of injury and surgery leading to multiple debridements, arthrodesis and even amputation 5, 6. The advent of minimally invasive techniques of internal fixation could not solve this challenge completely 7 …”

Section: Introductionmentioning

confidence: 99%

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Outcome of complex tibial plateau fractures with Ilizarov external fixation with or without minimal internal fixation

Subramanyam

Tammanaiah

Mundargi

et al. 2019

Chinese Journal of Traumatology

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Purpose To evaluate the clinico-radiological outcome of complex tibial plateau fractures treated with Ilizarov external fixation with or without minimal internal fixation. Methods This retrospective review was conducted on all the cases of Schatzker types V and VI tibial plateau fractures treated by Ilizarov external fixation between July 2006 and December 2015 with the minimum follow-up duration of one year. There were 30 patients: 24 males and 6 females, mean age 43.33 years, and mean follow-up 3.6 years. Three of them were open fractures; 15 cases were Schatzkertype V fractures and the other 15 type VI. According to AO/OTA classification, there were 11 type C1, 12 C2 and 7 type C3 fractures. Outcome assessment was made with American Knee Society Score (AKSS) and Rasmussen's Radiological Score (RRS) at final follow-up. Results Out of the 30 cases, mini-open reduction was performed in 7, bone graft in 4, minimal internal fixation in 10 and knee temporary immobilisation in 11 patients. Mean duration of external fixation was 11.8 weeks. All fractures united. Pin tract infections in 7 and common peroneal neuropathy in 2 patients were self-limiting. Two patients had axial misalignment of less than 10°. At final follow-up, the mean knee range of motion was 114.7, mean AKSS 81.5 and mean RRS 16.7. On statistical analysis, Schatzker type of fractures, use of minimal internal fixation and knee-spanning did not influence the final outcome. Conclusion Ilizarov external fixator with or without minimal internal fixation provides acceptable outcome for complex tibial plateau fractures. Care must be taken to look for minor loss of alignment, especially in Type VI Schatzker fractures after removal of the fixator. However small sample size precludes firm conclusions.

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“… 5 , 6 The advent of minimally invasive techniques of internal fixation could not solve this challenge completely. 7 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outcome of complex tibial plateau fractures with Ilizarov external fixation with or without minimal internal fixation

Subramanyam

Tammanaiah

Mundargi

et al. 2019

Chinese Journal of Traumatology

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show abstract

“…Dual (medial and lateral) incisions, locking fixation, and minimally invasive techniques have all reportedly contributed to fewer soft tissue and infectious complications. 17,21,31,[34][35][36][37][38] While two-stage treatment became a popular widespread practice, it is unclear to what extent this practice was responsible for improved results in the treatment of tibial plateau fractures compared to refined techniques of soft tissue dissection and implant evolution.…”

Section: Discussionmentioning

confidence: 99%

Costs and Complications of Single-Stage Fixation Versus 2-Stage Treatment of Select Bicondylar Tibial Plateau Fractures

Virkus

Caballero

Kempton

et al. 2018

Journal of Orthopaedic Trauma

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“…Locking plates are widely used for treatment of periarticular fractures, as they provide angular stability and may allow earlier motion and weight bearing, particularly when compared with fracture fixation with nonlocking plates [4, 5]. There has been renewed interest recently in the morphology of tibial plateau fractures, using computed tomography (CT) imaging [6, 7].…”

Section: Introductionmentioning

confidence: 99%

Tibia plateau fracture mapping and its influence on fracture fixation

et al. 2019

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Background Tibial plateau fracture classifications are based on anteroposterior radiographs. Precontoured locking plates are commonly used to treat such fractures. The aims of this study are to: (1) describe tibial plateau fracture anatomy in the axial plane and (2) assess whether current plating systems allow screws to be placed suitably. Materials and methods A graphical tibial plateau template was developed. One hundred twenty-five tibial plateau fractures (four bilateral) were reviewed (80 men, 41 women; average age 45.5 years, range 21–77.7 years). The axial computed tomography (CT) slice 0.3–0.5 mm below the medial articular surface was reviewed in all cases. Fracture lines were drawn on the template. Four lateral locking plates were placed against a cadaveric adult tibia. Based on the projected screw directions, suitable fracture patterns were identified. Fractures were considered “suitable” if the screws passed 90 ± 22° to the fracture line. Results Two hundred sixty-one different fracture lines were identified. One hundred thirty-four fractures involved the lateral plateau; 96 were suitable for lateral plating. Ninety fractures involved the medial plateau, 82 were treatable using the various plate positions on medial-posterior aspect of the medial plateau. Thirty-seven fractures were bicondylar; 20 were treatable with a posteromedial plate. Conclusions Tibial plateau fractures follow consistent patterns, with most lateral and medial plateau fracture lines being in the sagittal plane, although there is greater variation medially. Positioning of modern locking plates will deal effectively with 72 % of all lateral plateau fractures and 91 % of medial plateau fractures. Level of evidence Level 3.

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Dual locked plating of unstable bicondylar tibial plateau fractures

Cited by 30 publications

References 30 publications

Outcome of complex tibial plateau fractures with Ilizarov external fixation with or without minimal internal fixation

Outcome of complex tibial plateau fractures with Ilizarov external fixation with or without minimal internal fixation

Costs and Complications of Single-Stage Fixation Versus 2-Stage Treatment of Select Bicondylar Tibial Plateau Fractures

Tibia plateau fracture mapping and its influence on fracture fixation

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