The outcome after lateral tibial plateau fracture treated with percutaneus screw fixation show a tendency towards worse functional outcome compared with a reference population

Elsøe, Rasmus; Larsen, Peter; Shekhrajka, Nitesh; Ferreira, Luis Sigaard; Østgaard, Svend Erik; Rasmussen, Sten

doi:10.1007/s00068-015-0497-9

Cited by 17 publications

(22 citation statements)

References 32 publications

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“…Finally, 20 papers remained for analysis, of which 17 were in English, 2 in Chinese and 1 in Korean 8,11,13,14,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] . Specifically, there were 2 prospective comparative studies, 2 retrospective comparative studies, 15 case series, and 1 clinical series based on a technique note 8,11,13,14,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] . Levels of evidence (levels I-IV) for each study were examined and distinguished according to the content developed by the OCEBM (15) 6.0 AE1.8 Selection process (15) 11.9 AE2.6 Total score (100) 58.7 AE10…”

Section: Literature Search and Quality Assessmentmentioning

confidence: 99%

“…Specifically, there were 2 Level II studies, 2 Level III studies, and 16 Level IV studies 8,11,13,14,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] . Although 3 studies included a minority (<25%) of patients with complex or bicondylar fractures and should not be included in this review according to the exclusion criteria, the third reviewer finally decided to include these studies considering the fact that the clinical or radiological outcomes of each patient were specifically listed and the data of patients with monocondylar fractures could, therefore, be extracted for analysis 23,26,34 .…”

Section: Literature Search and Quality Assessmentmentioning

confidence: 99%

“…Of the 20 studies, 8 reported a combined of two or three reduction methods for the treatment of tibial plateau fractures 8,19,25,27,29,30,32,34 . A total of 126 patients were treated with the assistance of intraoperative fluoroscopy, 140 patients were treated with the assistance of arthroscopy, and 235 patients were reduced using both fluoroscopy and arthroscopy 8,11,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] . The type of graft material was variable between studies, including autografts, allografts, and bone substitute (mostly calcium phosphate bone cement).…”

Section: Surgical Interventionmentioning

confidence: 99%

“…The tibial plateau fractures were classified by the Schatzker classification system in 18 studies 11,13,14,[19][20][21][22][23][24][25][27][28][29][30][31][32][33][34] . Schatzker II and III fractures accounted for the majority of the patients included in these studies, with a proportion of 87.3% (range, 60% to 100%).…”

mentioning

confidence: 99%

“…A total of 555 (99%) patients suffered from monocondylar tibial plateau fractures according to these two classification systems. Thirteen studies summarized the cause of the injury and the corresponding case number 13,[21][22][23][24][25][26][28][29][30][31]33,34 . Although the cause of injury was variable between studies, traffic accident (150/351), sport injury (82/351), and fall injury (74/351) were the most frequent etiologies of the fracture.…”

mentioning

confidence: 99%

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Percutaneous Reduction and Internal Fixation for Monocondylar Fractures of Tibial Plateau: A Systematic Review

Chang

et al. 2018

Orthopaedic Surgery

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Instead of extensive dissection of soft tissue around the fracture site, percutaneous techniques have unique advantages in managing displaced fragments, including preservation of soft tissues, less blood loss, lower risk of complications, and earlier functional rehabilitation. However, there are few systematic reviews on the effects of percutaneous reduction and internal fixation (PRIF) for tibial plateau fractures. A systematic search of Cochrane, EMBASE, and MED-LINE databases was performed for all publicly available data in March 2017 regarding the use of PRIF in treating monocondylar tibial plateau fractures. Basic information of included articles, surgical information, clinical outcomes, and concomitant soft tissue injuries were collected for analysis. Finally, a total of 20 articles including 561 patients were retrieved. Traffic accident was the most common cause of injury. Percutaneous techniques using bone tamp reduction were described in all studies. The majority (≥85%) of patients were classified as excellent or good according to clinical and radiological Rasmussen scores. The overall complication rate was 6.6%, with loss of reduction the most frequent complication with an incidence of 2.4%. This systematic review indicated that PRIF was an optimal alternative that physicians should consider for the treatment of monocondylar tibial plateau fractures.

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Section: Literature Search and Quality Assessmentmentioning

confidence: 99%

Section: Literature Search and Quality Assessmentmentioning

confidence: 99%

Section: Surgical Interventionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Percutaneous Reduction and Internal Fixation for Monocondylar Fractures of Tibial Plateau: A Systematic Review

Chang

et al. 2018

Orthopaedic Surgery

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Interfragmentary compression force and fixation stability of lateral tibial plateau fractures in normal and osteoporotic bones

Jiang,

Xu,

et al. 2024

Journal Orthopaedic Research

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Lateral platform collapse in fixations of lateral tibial plateau fractures (TPFs) using either double‐lag screws fixation (DSF) or locking‐plate fixation (LPF) is not rare. This study aimed to explore the effect of enhancing the interfragmentary compression force (IFCF) on fixation stability in lateral TPFs in normal and osteoporotic bones using finite element analysis. Finite element models of DSF in normal bone and LPF in normal and osteoporotic bones were established to simulate the fixations of lateral TPF. After model validation, axial compressive forces of 500, 1000, 1500, and 2500 N to the tibial plateau along with an IFCF of 0, 100, 200, and 300 N were applied. The maximum axial micromotion of the lateral fragment (MAM‐LF), maximal translational micromotion of the lateral fragment (MTM‐LF), peak von Mises stress (VMS), and peak equivalent elastic strain of the lateral fragment (EES‐LF) were evaluated. The MAM‐LF showed a decreasing trend as the IFCF increased in all models. For DSF models, the peak VMS of implants increased as the IFCF increased when the axial loads were 500 and 1000 N. The peak EES‐LF decreased as the IFCF increased under axial loads of 1000, 1500, and 2500 N. For the normal and osteoporotic LPF models, the peak VMS of the implants decreased as the IFCF increased. Peak EES‐LF decreased as IFCF increased. In conclusion, enhancing IFCF was beneficial in improving the fixation stability of lateral TPF. The optimal IFCF for DSF and LPF should be as high as reasonably feasible.

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Tibial plateau fractures are associated with poor functional outcomes and a low conversion rate to total knee arthroplasty

Kraml,

Haslhofer,

Winkler

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe aim of this study was to analyse the functional outcome and the conversion rate to total knee arthroplasty (TKA) after surgically treated tibial plateau fractures (TPF).MethodsAll patients undergoing surgical treatment of TPF at a single institution between January 2003 and December 2019 were retrospectively reviewed. The Knee injury and Osteoarthritis Outcome Score (KOOS) and Tegner activity scale (TAS) were collected. The conversion rate to TKA was examined 2, 5, 7 and 10 years after surgical treatment of TPF.ResultsNinety‐four patients, with a mean follow‐up of 110.6 months (±60.0), were included in the functional outcome assessment. Mean KOOS scores were 75.4 for symptoms, 80.6 for pain, 84.3 for activities of daily living (ADL), 59.5 for sports and 61.3 for QOL. All subscales were significantly lower on the injured side compared with the contralateral leg. Lower KOOS was observed in patients with hardware removal and Schatzker type 5 and 6 injuries. Median TAS was postinjury (4) significantly lower than preinjury (5) (p < 0.001). The conversion rate to TKA was 6.3%, 10.9%, 11.7% and 12.2% after 2,5,7 and 10 years of follow‐up, respectively. Patients undergoing TKA were older than patients with no conversion to TKA (2 years follow‐up 53.8 vs. 64.5 years, p = 0.026).ConclusionTPFs decrease the function of the knee when compared with the contralateral side and to the preoperative condition. Bicondylar fractures are associated with worse functional outcomes. A conversion rate to TKA of 12.2% was found at 10 years follow‐up.Level of EvidenceLevel III.

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The outcome after lateral tibial plateau fracture treated with percutaneus screw fixation show a tendency towards worse functional outcome compared with a reference population

Cited by 17 publications

References 32 publications

Percutaneous Reduction and Internal Fixation for Monocondylar Fractures of Tibial Plateau: A Systematic Review

Percutaneous Reduction and Internal Fixation for Monocondylar Fractures of Tibial Plateau: A Systematic Review

Interfragmentary compression force and fixation stability of lateral tibial plateau fractures in normal and osteoporotic bones

Tibial plateau fractures are associated with poor functional outcomes and a low conversion rate to total knee arthroplasty

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