Factors predicting the development of early osteoarthritis following lateral tibial plateau fractures: mid-term clinical and radiographic outcomes of 73 operatively treated patients

Parkkinen, Markus; Madanat, Rami; Mustonen, Antti; Koskinen, Seppo; Paavola, Mika; Lindahl, Jan

doi:10.1177/1457496914520854

Cited by 95 publications

(69 citation statements)

References 34 publications

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“…In literature, this complication has been reported between 0% and 59% 25, 26, 27. The large variation in reporting could be due to different criteria used for evaluation, reliability of techniques used for measuring and quality of radiographs used for the purpose of evaluation.…”

Section: Discussionmentioning

confidence: 99%

Complications in the management of closed high-energy proximal tibial plateau fractures

Khatri

Goyal

et al. 2016

Chinese Journal of Traumatology

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PurposeTo report complications in the management of complex closed proximal tibial fractures.MethodA retrospective study was conducted to analyze the infectious and noninfectious complications encountered in the management of high-energy Schatzker type V and VI tibial plateau fractures. All patients were treated at the level 1 trauma centre between January 2011 and March 2014. Sixty two patients were included in the study. The mean patient age was (43.16 ± 11.59) years with 60 males and 2 females. Infectious complications like superficial and deep infection, wound dehiscence, malalignment in the immediate postoperative period and in follow-up period were noted.ResultsThe overall complication rate was 30.65% (19 out of 62). Infectious complications were noted in 20.97% cases (13/62). In majority of the cases (8/13), superficial infection was seen which managed with regular dressing and antibiotic administration. The patients (5/13) who had developed deep-seated infection were subjected to repeated debridements, flap coverage, implant removal or amputation depending upon the host response. Thirteen patients had experienced noninfectious complications. Hardware related complications were noticed in six patients and four among them received a secondary procedure. Malalignment was observed in seven patients but only single patient underwent subsequent operative intervention.ConclusionProximal tibial plateau fractures especially Shatzker type V and VI are associated with extensive soft tissue damage even in closed injuries. The complications encountered in the management of these fractures can be minimized with appropriate patient selection and minimal soft tissue dissection.

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Section: Discussionmentioning

confidence: 99%

Complications in the management of closed high-energy proximal tibial plateau fractures

Khatri

Goyal

et al. 2016

Chinese Journal of Traumatology

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“…, 19 In addition to all initial articular cartilage damage was accused for the development of arthritis 20 …”

Section: Discussionmentioning

confidence: 99%

Subchondral raft construction with locking plates for the treatment of Schatzker type II fractures

et al. 2017

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OBJECTIVES: To evaluate the functional and radiological results of Schatzker type II fractures treated via subchondral raft screws combined with locking plates. METHODS: Twenty-four individuals were enrolled in this study between 2010 and 2014. The depressed joint line was elevated and the defect was filled with allograft. Next, two or three subchondral screws were placed in combination with a locking plate. At the last follow-up, clinical and radiological data were recorded. RESULTS: The mean follow-up period was 21.4 months (12-39). The mean Knee Society Score (KSS) and Rasmussen clinical scores were 91.5 (range, 77-100) and 16.75 (range, 14-18), respectively. The mean Rasmussen radiological score was 27.9 (range, 24-30) during the follow-up. There was no statistically significant difference between injured and non-injured sides with respect to the mechanical axis, the proximal medial tibial angle, and tibial slope. In addition, arthritis showed no difference on the non-injured side, although follow-up was short. CONCLUSIONS: The periarticular raft construction combined with the locking plate helps surgeon to maintain the anatomic line of the joint and the mechanical axis obtained during the surgery. Secondary arthritis seems to be major complication after fractures of the tibial plateau, although the functional results were satisfactory. Level of Evidence IV, Case Series.

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“…Blokker et al suggested surgical treatment when the articular surface depression was > 5 mm (8). Reduction of the articular surface by plate and screws can also reduce the risk of degenerative changes of the knee (24). …”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Tibial Plateau Fractures With 3.5 mm Simple Plates

Bagherifard¹,

Hadi²,

Rahbar³

et al. 2016

Trauma Mon

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BackgroundTibial plateau fractures can be successfully fixed utilizing 3.5 mm locking plates. However, there are some disadvantages to using these plates.ObjectivesIn the current prospective study, we investigated the outcome of treating different types of tibial plateau fractures with 3.5 mm simple plates which, to our knowledge, has not been evaluated in previous studies.Materials and MethodsBetween 2011 and 2013, 32 patients aged 40 ± 0.2 years underwent open reduction and internal fixation for tibial plateau fractures with 3.5 mm simple plates. The patients were followed for 16.14 ± 2.1 months. At each patient’s final visit, the articular surface depression, medial proximal tibial angle, and slope angle were measured and compared with measurements taken early after the operation. The functional outcomes were measured with the WOMAC and Lysholm knee scores.ResultsThe mean union time was 13 ± 1.2 weeks. The mean knee range of motion was 116.8° ± 3.3°. The mean WOMAC and Lysholm scores were 83.5 ± 1.8 and 76.8 ± 1.6, respectively. On the early postoperative and final X-rays, 87.5% and 84% of patients, respectively, had acceptable reduction. Medial proximal tibial and slope angles did not change significantly by the last visit. No patient was found to have complications related to the type of plate.ConclusionsIn this case series study, the fixation of different types of tibial plateau fractures with 3.5 mm simple non-locking and non-precontoured plates was associated with acceptable clinical, functional, and radiographic outcomes. Based on the advantages and costs of these plates, the authors recommend using 3.5 mm simple plates for different types of tibial plateau fractures.

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Factors predicting the development of early osteoarthritis following lateral tibial plateau fractures: mid-term clinical and radiographic outcomes of 73 operatively treated patients

Cited by 95 publications

References 34 publications

Complications in the management of closed high-energy proximal tibial plateau fractures

Complications in the management of closed high-energy proximal tibial plateau fractures

Subchondral raft construction with locking plates for the treatment of Schatzker type II fractures

Surgical Management of Tibial Plateau Fractures With 3.5 mm Simple Plates

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