Effect of fracturoscopy on the incidence of surgical site infections post tibial plateau fracture surgery

Henkelmann, Ralf; Krause, Matthias; Alm, Lena; Glaab, Richard; Mende, Meinhard; Ull, Christopher; Braun, P; Katthagen, Christoph; Gensior, Tobias J.; Frosch, Karl‐Heinz; Hepp, Pierre

doi:10.1007/s00068-020-01486-y

Cited by 10 publications

(6 citation statements)

References 17 publications

(23 reference statements)

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“…Clinical resolution of infection occurred after an average of 3.3 additional procedures (55). In 2000 patients treated with ORIF by henkelman et al in 2020, the rate of surgical site infection was 4.7% (93/2000) (56). In 2022, the rate of deep infection in OTA/AO type C tibial plateau reported by Bullock et al was 6% (57).…”

Section: Infectionmentioning

confidence: 98%

Complications of the surgical treatment of fractures of the tibial plateau: prevalence, causes, and management

2022

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Open reduction and internal fixation is the gold standard treatment for tibial plateau fractures. However, the procedure is not free of complications such as knee stiffness, acute infection, chronic infection (osteomyelitis), malunion, non-union, and post-traumatic osteoarthritis. The treatment options for knee stiffness are mobilisation under anaesthesia (MUA) when the duration is less than 3 months, arthroscopic release when the duration is between 3 and 6 months, and open release for refractory cases or cases lasting more than 6 months. Early arthroscopic release can be associated with MUA. Regarding treatment of acute infection, if the fracture has healed, the hardware can be removed, and lavage and debridement can be performed along with antibiotic therapy. If the fracture has not healed, the hardware is retained, and lavage, debridement, and antibiotic therapy are performed (sometimes more than once until the fracture heals). Fracture stability is important not only for healing but also for resolving the infection. In cases of osteomyelitis, treatment should be performed in stages: aggressive debridement of devitalised tissue and bone, antibiotic spacing and temporary external fixation until the infection is resolved (first stage), followed by definitive surgery with grafting or soft tissue coverage depending on the bone defect (second stage). Intra-articular or extra-articular osteotomy is a good option to correct malunion in young, active patients without significant joint damage. When malunion is associated with extensive joint involvement or the initial cartilage damage has resulted in knee osteoarthritis, the surgical option is total knee arthroplasty.

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Section: Infectionmentioning

confidence: 98%

Complications of the surgical treatment of fractures of the tibial plateau: prevalence, causes, and management

2022

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“…Compared with open reduction internal fixation, the ARIF technique has been proven to lead to faster postoperative recovery and better clinical outcomes in the treatment of tibial fractures [ 24 ]. Moreover, the severe knee injuries are at higher risk of infection, and the ARIF technique can reduce the rates of surgical site infections [ 25 ]. Therefore, we finally chose ARIF technique to treat anteromedial tibial plateau fracture.…”

Section: Discussionmentioning

confidence: 99%

Single-stage arthroscopic-assisted treatment of anteromedial tibial plateau fracture with posterolateral corner injury: a retrospective study

et al. 2022

BMC Musculoskelet Disord

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Background Anteromedial tibial plateau fracture with posterolateral corner (PLC) injury is a relatively rare combined injury in the clinic. In addition, there is no unified treatment scheme for this combined injury. The purpose of this study was to evaluate the clinical and imaging results of single-stage arthroscopic-assisted surgery for anteromedial tibial plateau fracture with PLC injury, and to explore the advantages of this surgical technique. Method In this retrospective study, a total of 9 patients (7 males and 2 females) were included, aged 24–64 years (average 40.7 years), treated in our Department of Orthopedics from January 2016 to January 2021. In the preoperative evaluations, there were 9 cases of anteromedial tibial plateau fractures with PLC injuries, 6 cases of concomitant PCL injuries, 6 cases of concomitant medial or lateral meniscus injuries, and 2 cases of concomitant fibular head avulsion fractures. All patients underwent single-stage arthroscopic-assisted surgery. Results All patients were followed up, and the average follow-up period was 15.2 months (range 12–18 months). The average operation time was 135.6 min (range 100–160 min), and the average surgical blood loss was 87.2 ml (range 60–110 ml). The anatomical reduction was achieved in 9 cases, and the anatomical reduction rate was 100%. The average fracture healing time was 13.1 weeks (range 12–16 weeks). At the last follow-up, the average VAS score was 1 (range 0–2); the average Lysholm function score was 90.7 (range 86–95), and the average IKDC score was 91.4 (range 88–95); the average knee extension angle of all patients was 0° and the average knee flexion angle was 128.3° (average 120–135°); The posterior drawer test, the Lachman test and the dial test were negative for all cases. None of the patients had operation-related complications. Conclusion Single-stage arthroscopy-assisted surgery in the treatment of anteromedial tibial plateau fracture with PLC injury can achieve good clinical outcomes, restore the stability of the knee joint, and reduce the risk of severe lower extremity dysfunction.

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“…Some scholars pointed out that 60 patients with tibial plateau fractures suffered from low energy injury and were treated by internal plate fixation [ 22 ]. The patients were followed up for one year, and the results showed that the excellent and good rate of knee joint function recovery was only 85% and 15% of the patients had knee traumatic arthritis [ 23 ]. When observing the X-ray films of the patients' knee joints, it was found that different degrees of degeneration could be observed in the patients' knee joints, accounting for 30%.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Risk Factors and Surgical Strategy of Knee Traumatic Arthritis after Internal Plate Fixation in the Treatment of Tibial Plateau Fracture

Jin¹,

Li²,

Yang³

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. To explore the risk factors and surgical strategies of knee traumatic arthritis after internal plate fixation in the treatment of tibial plateau fracture. Methods. A total of 300 patients with tibial plateau fractures treated with internal plate fixation in our hospital from January 2019 to April 2021 were retrospectively analyzed. According to whether secondary knee traumatic arthritis occurred after operation, they were divided into control group and research group. The control group was nonsecondary knee traumatic arthritis ( n = 231 ), and the research group was secondary knee traumatic arthritis ( n = 69 ). Univariate and multivariate logistic regression analysis was used in this research. Results. There were significant differences in fracture classification, injury method, osteoporosis, and the time from injury to operation between the two groups, and there are statistically significant differences between groups ( P < 0.05 ). Fracture type, injury method, osteoporosis, and time from injury to operation were the influencing factors of tibial internal fixation, and there are statistically significant differences between groups ( P < 0.05 ). Platform fracture was an independent risk factor for postoperative knee joint traumatic arthritis, and there are statistically significant differences between groups ( P < 0.05 ). The HSS scores of both groups increased after operation, and there are statistically significant differences between groups ( P < 0.05 ). No loosening of the prosthesis was found in all 69 patients with postoperative X-ray examination. Conclusion. Fracture classification, injury mode, osteoporosis, and time from injury to operation are independent risk factors for knee traumatic arthritis in the treatment of tibial plateau fractures with internal plate fixation, incidence of knee trauma.

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Effect of fracturoscopy on the incidence of surgical site infections post tibial plateau fracture surgery

Cited by 10 publications

References 17 publications

Complications of the surgical treatment of fractures of the tibial plateau: prevalence, causes, and management

Complications of the surgical treatment of fractures of the tibial plateau: prevalence, causes, and management

Single-stage arthroscopic-assisted treatment of anteromedial tibial plateau fracture with posterolateral corner injury: a retrospective study

Analysis of Risk Factors and Surgical Strategy of Knee Traumatic Arthritis after Internal Plate Fixation in the Treatment of Tibial Plateau Fracture

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