scholarly journals Interest of PMMA filing to primary stabilization of the minimaly invasive osteosynthesis of schatzker type II tibial Plateau fractures

2019 ◽  
Vol 22 (sup1) ◽  
pp. S289-S290
Author(s):  
T. Vendeuvre ◽  
C. Brèque ◽  
M. Severyns ◽  
A. Ounajim ◽  
J.-P. Richer ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Tibial Plateau Fractures ◽  
Type Ii ◽  
Schatzker Type

scholarly journals Arthroscopic Assisted Reduction and Internal Fixation of Tibial Plateau Fractures

2019 ◽  
Vol 7 (7) ◽  
pp. 1133-1137 ◽  
Author(s):  
Sherif Hamdy Mohamed Zawam ◽  
Ahmed Mahmoud Gad
Keyword(s):  
Internal Fixation ◽  
Tibial Plateau ◽  
Articular Surface ◽  
Knee Injuries ◽  
Tibial Plateau Fractures ◽  
Type I ◽  
Type Ii ◽  
University Hospitals ◽  
Type Iii ◽  
Schatzker Type

BACKGROUND: Tibial plateau fractures present an important entity in orthopaedic fractures. Arthroscopic-assisted reduction and internal fixation is a good alternative to ORIF as it has the advantage of direct visualisation of the articular surface of the plateau, direct assessment of the reduction of the articular surface, and managing any associated intra-articular pathology. AIM: Our study aim is to determine the results of arthroscopic assisted reduction and internal fixation of tibial plateau fractures. METHODS: This study involved 25 patients with tibial plateau fractures presenting to the emergency department of Cairo University Hospitals between the periods of November 2016 and May 2017. The patients were followed up for an average of 14 months (11-18 months). According to Schatzker’s classification, five patients had type I, eleven had type II, and nine patients had type III fractures. RESULTS: The average time to full union in Schatzker type I was 9.1 weeks, in type II was 10.2 weeks, and in type III it was 9.4. The mean clinical Rasmussen score among the 25 patients was 26 (range, 24-30). A group of 19 patients (76%) had excellent results, (4 type I, 8 types II, and 7 types III) 6 patients (24 %) had good results (1 type I, 3 types II, 2 types III). Radiologic results were excellent in (14 cases) 56.0% and good results (11 cases) 44%. CONCLUSION: Arthroscopic assisted reduction and fixation of tibial plateau fractures have the advantages of checking the adequacy of reduction, avoiding the need for detachment of the meniscus, and allowing for accurate diagnosis and management of associated knee injuries. Therefore, we recommend that arthroscopic assisted reduction and fixation of tibial plateau fractures should be used more often.

scholarly journals Treatment of Tibial Plateau Fractures Involving Posterolateral Column Through the Extended Anterolateral Approach

2021 ◽  
Author(s):  
Wenwen Mao ◽  
Li Li ◽  
Gang Chen ◽  
Ming Zhang ◽  
Yousen Zhu ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Stress Test ◽  
Locking Compression Plate ◽  
Tibial Plateau Fractures ◽  
Anterolateral Approach ◽  
Type Ii ◽  
Schatzker Type ◽  
Compression Plate ◽  
Type V

Abstract ObjectiveTo summarize the surgical technique and the clinical effects of extended anterolateral approach for the treatment of Schatzker type II and Schatzker type V/VI which involving the posterolateral column tibial plateau.MethodsFrom January 2015 through December 2018, a total of 28 patients with tibial plateau fracture involving posterolateral column were included in this study. Among them, 16 patients were Schatzker type II treated via extended anterolateral approach with lateral tibial locking compression plate fixation.12 patients were Schatzker type V or VI treated via extended anterolateral combine with medial approach by lateral tibial locking compression plate plus medial locking compression plate fixation. All cases were followed up for 15~31 months, with an average follow‐up of 22.5±3.7 months. During the follow-up, the tibial plateau angle (TPA), lateral posterior angle (PA) and Rasmussen radiological criteria were used to evaluate the effect of fracture reduction and fixation; the Hospital for Special Surgery (HSS) and the range of motion were used to evaluate knee function; the Lachman and knee Valgus (Varus) stress test were used to evaluate anteroposterior and lateral stability of the knee.ResultsAll fractures healed. At the 12-month follow-up: in Schatzker type II group a mean TPA of 86.38±3.92°, a mean PA of 7.43±2.68°, and Rasmussen radiological score with an average of 16.00±2.06 points, scores were excellent in 6 cases and good in 10 cases, as a result the excellent and good rate was 100%; while in in Schatzker type V/VI group a mean TPA of 84.91±3.51°, a mean PA of 9.68±4.01°, and Rasmussen radiological score with an average of 15.33±2.99 points, scores were excellent in 4 cases and good in 6 cases, as a result the excellent and good rate was 83.33%. During the one-year follow-up, when re-measured postoperative PA, TPA, Rasmussen score of the two groups did not change significantly (P > 0.05). At the last follow‐up, in Schatzker type II group, the the knee flexion angle was 110° ~135°, with an average of 125°±8.56°,a mean of HHS score 88.37±10.01 points, scores were excellent in 9 cases and good in 5 cases, as a result the excellent and good rate was 100%; in Schatzker type V/VI group, the the knee flexion angle was 100° ~130°, with an average of 120°±11.25°,a mean of HHS score 82.17±10.76 points, scores were excellent in 5 cases and good in 3 cases, as a result the excellent and good rate was 66,67%.In addition, up to the last follow-up, Lachman and knee Valgus (Varus) stress test results of the two groups were negative. No complications were found.ConclusionsAlthough there are many ways to treat posterolateral tibial plateau fractures, When choosing one or more combined approach, we must consider the condition of soft tissue injury, the shape of the whole platform fracture including the posterolateral bone block and the available fixation methods. The best approaches should provide maximum exposure of the platform, enough space for reduction and fixation, and minimum damage to the surrounding structures. For anterolateral platform fractures combine with isolated posterolateral fracture fragments, the extended anterolateral approach is more suitable as a single approach. For multiple column tibial plateau fractures a dual approach (extended anterolateral combined with medial approach) can be used to enter the whole plateau area.

scholarly journals "MORIEF Technique" for Schatzker Type II–III Tibial Plateau Fractures with Tension Blisters: A Retrospective Study of Seven Patients

2021 ◽  
Author(s):  
Xin Qi ◽  
Yong-Qing Xu ◽  
Hong-Bo Tan ◽  
Shen Xia ◽  
Xiao-Yan Xu ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Weight Bearing ◽  
Clinical Score ◽  
Tibial Plateau Fractures ◽  
Functional Score ◽  
Type Ii ◽  
Joint Function ◽  
Schatzker Type ◽  
Needle Tract

Abstract Background: When tibial plateau fractures are combined with tension blisters, internal fixation surgery must be delayed. However, a prolonged delay may cause complications during fracture treatment. To combat this challenge, we innovatively proposed a minimally open reduction and Ilizarov external fixation (MORIEF) technology. Therefore, the present study aimed to explore the treatment, safety, and efficacy of the MORIEF technique in Schatzker type II–III tibial plateau fractures with tension blisters.Methods: We retrospectively analyzed data of seven patients with Schatzker type II–III tibial plateau fractures with tension blisters treated at our hospital from September 2013 to March 2017. All patients (five males, two females; mean age: 38.1±8.2 [range: 28–50] years) underwent the MORIEF technique. The Knee Society Score (KSS) and assessment of bone status according to the Association for the Study and Application of the Method of Ilizarov (ASAMI) scoring system were used to evaluate the knee joint function and bone healing condition.Results: The operative time was 108.6±14.6 (range: 90–135) min, blood loss was 104.3±50.4 (range: 50–200) ml, time from operation to discharge was 2.6±0.7 (range: 2–4) days, and the follow-up period was 20.6±1.8 (range: 18–22) weeks. The fractures healed in all patients at 11.9±1.1 (range: 10–14) weeks. Except for one case of needle tract infection, no other complications occurred. At the last follow-up, the KSS presented a clinical score of 80–95 (mean: 86.4±4.4) points and a functional score of 85–95 (mean: 87.9±3.6) points. According to ASAMI, four cases were classified as excellent, two as good, one as fair, and none as poor.Conclusions: The use of the MORIEF technology for the treatment of Schatzker type II–III tibial plateau fractures with tension blisters showed that the resulting incidence of infection is low, weight-bearing and walking can be resumed immediately, hospitalization time is shortened, economic burden of patients is reduced, and fracture healing and joint function recovery are not affected postoperatively. Therefore, this technique was shown to be a relatively safe and effective treatment method for the condition.

scholarly journals Treatment of Schatzker Type II-VI Tibial Plateau Fractures by Means of Syndesmotaxis Using an Ilizarov External Fixator and Postoperative CT Evaluation

Cureus ◽  
2021 ◽  
Author(s):  
Stamatios A Papadakis ◽  
Dimitrios Pallis ◽  
Margarita-Michaela Ampadiotaki ◽  
Georgios Gourtzelidis ◽  
Konstantinos Kateros ◽  
...  
Keyword(s):  
External Fixator ◽  
Tibial Plateau ◽  
Tibial Plateau Fractures ◽  
Type Ii ◽  
Ilizarov External Fixator ◽  
Schatzker Type ◽  
Ct Evaluation

scholarly journals The Medial Approach for Arthroscopic-Assisted Fixation of Lateral Tibial Plateau Fractures

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0021
Author(s):  
Nurzat Elmali ◽  
Özgür Baysal ◽  
Mustafa Karakaplan ◽  
Deniz Gülabi ◽  
Fevzi Sağlam
Keyword(s):  
Tibial Plateau ◽  
Weight Bearing ◽  
Vascular Supply ◽  
Tibial Plateau Fractures ◽  
Fracture Reduction ◽  
Meniscus Tear ◽  
Type Ii ◽  
Lateral Tibial Plateau ◽  
Medial Approach ◽  
Schatzker Type

Objectives: Tibial plateau fractures are complex injuries involving the weight bearing surface of the tibia. Open reduction and internal fixation with plates and screws is an established method of treatment for complex fractures (Schatzker types V–VI). Arthroscopically assisted techniques have been used successfully for simple fractures (Schatzker types I–III). Historically, arthroscopic-assisted reduction for lateral tibial plateau fractures have been performed through a laterally based metaphyseal window. We found this technique to have several limitations, including bone grafting through a short subchondral tunnel. Also, there was a risk of lateral vascular supply distrubtion. We proposed that medial window approach technique would provide a longer tunnel for subchondral support and aid in fracture reduction. We aimed to present our initial experiences in first seven cases approaching lateral tibial plateau fractures through a medial metaphyseal window. Methods: Our series involves 7 patients with 5 Schatzker type II and 2 Schatzker type III lateral tibial plateau fractures treated by a single surgeon, using a medial approach for the arthroscopic assisted fixation. There were 5 males and 2 females. The average age at the time of surgery was 34.2 years, (29-52). All of the patients underwent plain radiography and CT scanning in each knee Time from injury to surgery was 7.2 days (4-12 days). Length of follow up was 9 months (6-22 months). There was 2 lateral meniscus tear that treated with partial meniscectomy and 1 MCL injury that treated conservativeely. Surgery was performed in four steps. First step was diagnostic arthroscopy of the injured knee, , second step was reduction of the fracture using a sylindiric tube with fluoroscopic guidance, third step was the arthroscopic verification of the fracture reduction, and finally percutaneous osteosynthesis of the fracture.Care is taken to keep the flow to gravity or, if using a pressure controlled pump, to set the pressure at approximately 40 millimeters of mercury. This will help alleviate the risk of compartment syndrome. Compartment firmness should be continuously monitored throughout the procedure. Results: No complications related to the procedure were observed. All patients reported a relevant reduction in pain, were able to mobilize with full weight bearing in the average 12 weeks (9–15 weeks). No secondary loss of reduction was observed in radiological controls; No revision surgery was required. Functional assessment according to HSS (hospital for special surgery) of the patients were excellent in 5 cases, good in 2 cases. Conclusion: Because depressed fragments are elevated from distal cortical windows, the importance of an intact, or easily restored, “cortical envelope” is paramount. In most Schatzker Type II and III fractures, the cortical envelope is either intact or can easily be restored with a clamp. The main advantage of medial approach for these fracture patterns is the creation of a long tunnel for subchondral support, the ease of fracture reduction and saving the lateral vascular supply.

scholarly journals A retrospective clinical control study of extended anterolateral approach and Frosch approach in Schatzker type II tibial plateau fractures involving  the posterolateral  column

2020 ◽  
Author(s):  
Yongqing Yan ◽  
Renjie Xu ◽  
Xinhua Yuan
Keyword(s):  
Tibial Plateau ◽  
Operation Time ◽  
General Information ◽  
Tibial Plateau Fractures ◽  
Control Group ◽  
Anterolateral Approach ◽  
Type Ii ◽  
Schatzker Type ◽  
Hss Score ◽  
Control Study

Abstract Objective: To compare the extended anterolateral approach with the Frosch approach in the treatment of Schatzker type II tibial plateau fractures involving the posterolateral column. Methods: A retrospective case-control study was conducted to compare the general information, intraoperative and postoperative situations, HSS score and Rasmussen radiology score, TPA, and PSA immediately after the operation and at one-year follow-up.Results: There was no statistical difference between the two groups in general information, which was comparable. The operation time in the Frosch group was slightly higher than those in the control group, while the HSS score and Rasmussen radiology score were better than those in the control group.Conclusion: In the case with simple posterolateral fragments, the extended anterolateral approach and the Frosch approach can both achieve better outcomes. While in the case of complex posterolateral fragments, the Frosch approach can provide more accurate reduction and better biomechanical stability.

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