Treatment of Schatzker Type V and VI Tibial Plateau Fractures Using a Midline Longitudinal Incision and Dual Plating

Abstract

PurposeThe purpose of this study was to evaluate the results of the treatment of Schatzker type V and VI tibial plateau fractures using a midline longitudinal incision and dual-plate fixation.Materials and MethodsTen patients with Schatzker type V and VI tibial plateau fractures treated with a midline longitudinal incision and dual plating were analyzed. The patients were followed for a minimum of one year. Clinical outcomes were evaluated using range of motion, visual analogue scale (VAS) and Knee Society Score. Radiological outcomes were evaluated using the bony union time, medial proximal tibial angle (MPTA) and posterior proximal tibial angle (PPTA).ResultsThe mean VAS score was 2.2 points, and the mean Knee Society function score was 85 points at the final follow-up. The mean flexion contracture was 2.5° and the mean further flexion was 125°. It took an average of 4 months until bony union occurred. The mean MPTA and PPTA were 90.5° and 4.4°, respectively. There was one case of delayed wound healing, but no other complications were observed.ConclusionsThe treatment of Schatzker type V and VI tibial plateau fractures with a midline longitudinal incision and dual-plate fixation resulted in satisfactory clinical and radiological outcomes. This can be an option when treating Schatzker type V and VI tibial plateau fractures.

Second Place Award Immediate versus delayed operative treatment of low-energy tibial plateau fractures

“…A recent report out of Korea followed 10 patients treated with dual plating of a high-energy plateau fracture through a midline incision. They reported zero infections and only one instance of delayed wound healing that resolved without a return to the operating room 27. These reports show the safety of an anterior approach in high-energy injuries where soft tissues are more often a concern.…”

Bicondylar Tibial Plateau Fractures: Assessing and Treating the Medial Fragment

“…In this small series of 10 patients, there was 1 instance of delayed healing and no deep infections. 7 Concern for infection and other complications led to an increased interest in spanning external fixation with minimal percutaneous intervention as a possible definitive treatment option. Despite lower rates of surgical complications, 8 the inability to ensure anatomic reduction of the tibial plateau articular surface and inability to address meniscal pathology remains a problem for this treatment method 9 and residual articular malreduction is thought to correlate with poor outcomes.…”

Surgical Management of Bicondylar Tibia Fractures

“…Большое значение для результативности открытого остеосинтеза переломов проксимального отдела ББК имеет выбор адекватного хирургического доступа [11,18]. Однако большинство известных доступов, особенно к наружному мыщелку большеберцовой кости, не обеспечивают адекватной визуализации костно-травматического дефекта и не позволяют оценить всю суставную поверхность латерального плато или же являются высокотравматичными [23,26].…”