Outcomes of Schatzker II Tibial Plateau Fracture Open Reduction Internal Fixation Using Structural Bone Allograft

2014 ◽  
Vol 28 (2) ◽  
pp. 97-102 ◽  
Author(s):  
Marschall B. Berkes ◽  
Milton T.M. Little ◽  
Patrick C. Schottel ◽  
Nadine C. Pardee ◽  
Aernout Zuiderbaan ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Bone Allograft ◽  
Open Reduction Internal Fixation ◽  
Plateau Fracture

scholarly journals Arthroscopy-Assisted Reduction Percutaneous Internal Fixation Versus Open Reduction Internal Fixation for Tibial Plateau Fracture: A Systematic Review and Meta-analysis

2021 ◽  
Vol 9 (12) ◽  
pp. 232596712110278
Author(s):  
Liangjun Jiang ◽  
Erman Chen ◽  
Lu Huang ◽  
Cong Wang
Keyword(s):  
Systematic Review ◽  
Internal Fixation ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Open Reduction Internal Fixation ◽  
Radiological Evaluation ◽  
Plateau Fracture ◽  
Mean Differences ◽  
Percutaneous Internal Fixation

Background: Arthroscopy-assisted reduction percutaneous internal fixation (ARIF) has emerged recently as an alternative treatment method in treating lower-energy tibial plateau fractures. To date, the comparison of clinical efficacy between ARIF and open reduction internal fixation (ORIF) is limited, with divergent conclusions. Purpose: To review studies on the clinical efficacy of ARIF and ORIF in the treatment of tibial plateau fracture. Study Design: Systematic review; Level of evidence, 3. Methods: A search was conducted using the PubMed, Web of Science, Cochrane Library, and EMBASE databases between inception and August 20, 2020, for retrospective and prospective studies evaluating ARIF versus ORIF in the treatment of tibial plateau fracture. We identified 6 clinical studies that met the inclusion criteria, with 231 patients treated with ARIF and 386 patients treated with ORIF. The risk of bias and the quality of evidence of the included studies were assessed. The 2 treatment types were compared in terms of clinical results and complications by using odds ratios (ORs), mean differences (MDs), or standardized mean differences (SMDs), with 95% confidence intervals (CIs). Heterogeneity among studies was quantified using the I 2 statistic. Results: The quality of the studies was high. Compared with ORIF, treatment with ARIF led to better clinical function (SMD = 0.31; 95% CI, 0.14 to 0.48; I 2 = 15%; P = .0005), shorter hospital stay (MD = –2.37; 95% CI, –2.92 to –1.81; I 2 = 0%; P < .001), and more intra-articular lesions found intraoperatively (OR = 3.76; 95% CI, 1.49 to 9.49; I 2 = 66%; P = .005). There were no complications or significant differences between the techniques in the radiological evaluation of reduction. Conclusion: Compared with ORIF, the ARIF technique for tibial plateau fractures led to faster postoperative recovery and better clinical function and the ability to find and treat more intra-articular lesions during the operation. However, the radiological evaluation of reduction and complications were not significantly different between the 2 groups.

scholarly journals Incidence and risk factors for decreased range of motion of the knee joint after surgery for closed tibial plateau fracture in adults

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Junyong Li ◽  
Junzhe Zhang ◽  
Kuo Zhao ◽  
Yanbin Zhu ◽  
Hongyu Meng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Knee Joint ◽  
Internal Fixation ◽  
Range Of Motion ◽  
Odds Ratio ◽  
Open Reduction ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Plateau Fracture ◽  
Independent Risk Factors

Abstract Purpose The aim of this study was to quantify the incidence of and identify independent risk factors for decreased range of motion (ROM) of the knee joint after surgery for closed tibial plateau fractures in adults. Methods This retrospective study was performed at the trauma centre in our hospital from January 2018 to December 2019. Data from adult patients with tibial plateau fractures treated by surgery were extracted from the electronic medical records. A total of 220 tibial plateau fracture patients were enrolled. We extracted the patients’ demographic characteristics, fracture characteristics, and surgery-related variables. Univariate and multivariate logistic regression models were used to investigate the potential independent risk factors. Results Fifty-seven patients developed decreased ROM of the knee joint at the 1-year follow-up in this study. The overall incidence was 25.9%. The independent predictors of decreased ROM after surgery, as identified in the multivariate analysis, were orthopedic polytrauma (odds ratio = 3.23; 95% CI = 1.68–6.20; p = 0.000), fracture type (Schatzker V-VI) (odds ratio = 2.52; 95% CI = 1.16–5.47; p = 0.019), and an open reduction and internal fixation approach (odds ratio = 2.10; 95% CI = 1.07–4.12; p = 0.031). Conclusions The study confirmed that patients with orthopaedic polytrauma, more complex fractures and those treated with open reduction and internal fixation (ORIF) surgery were more likely to suffer decreased ROM of the knee joint 1 year after surgery.

scholarly journals Augmentation by Rafting Screw on Fixation of the Lateral Tibial Plateau Fractures

2020 ◽  
pp. 256-271
Author(s):  
Osama El Sayed Ali Hegazy ◽  
Mohamed Abd El Hameid Romeih ◽  
Ashraf Atef Mahmoud ◽  
Nabil Omar Gharbo
Keyword(s):  
Internal Fixation ◽  
Bone Grafting ◽  
Scoring System ◽  
Open Reduction ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Type Ii ◽  
Type Iii ◽  
Schatzker Type ◽  
Plateau Fracture

Background: Tibial plateau fracture is considered one of the most common intra-articular fractures, especially lateral condyle fractures. The purpose of this study is to evaluate clinical, radiological, and functional outcomes of using subchondral periarticular rafting screw above a lateral plate without bone grafting or substitute for Schatzker type II and type III fractures. Methods: This prospective study was carried out on 43 patients above the age of 18, fit for surgery with closed tibial plateau fracture [lateral split depression (type II) and lateral depression (type III) according to Schatzker classification] time of trauma less than 14 days with no other skeletal injuries. All patients were followed up for at least six months. All patients were treated by open reduction and internal fixation (ORIF) and using subchondral periarticular screws as rafting construct to maintain articular surface and protect it from collapse. Analysis of clinical outcome was clinically based on Modified Rasmussen clinical scoring system and radiologically based on Rasmussen radiological knee scoring system. Results: In our study, 28 females and 15 males with a mean age of 49.5 years, mechanisms of trauma were road traffic accidents in 26 cases, and fall from height in 17 cases, 24 cases with Schatzker type II fracture, and 19 with type III. According to functional Rasmussen score, acceptable results were 93.1%, (76.8% excellent & 11.6% good) while non-acceptable results were 6.9%, (4.6% fair & 2.3% poor). According to radiological Rasmussen score, acceptable results were 83.7%, (65% excellent & 18.7% good) while non-acceptable results were 16.3%, (9.3% & 7%). No significant difference was found between the studied groups regarding sex, side affected, type of fracture, and type of trauma. The final outcome was significantly affected by age, medical history. Conclusions: Fixation using a subchondral periarticular rafting screws for lateral split-depression and lateral depression tibial plateau fractures without using bone graft or bone substitutes is a viable and good option during open reduction and internal fixation, helps surgeons achieve and preserve the anatomic joint line and normal mechanical axis, with superior functional results in the short term. Therefore, avoiding morbidity associated with bone grafting without compromising the fracture stability.

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

2020 ◽  
Vol 46 (6) ◽  
pp. 1249-1255 ◽  
Author(s):  
Ralf Henkelmann ◽  
Matthias Krause ◽  
Lena Alm ◽  
Richard Glaab ◽  
Meinhard Mende ◽  
...  
Keyword(s):  
Multicentre Study ◽  
Internal Fixation ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Selection Procedure ◽  
Surgical Site Infections ◽  
Information Criterion ◽  
Level Of Evidence ◽  
Plateau Fracture ◽  
Positive Effect

Abstract Purpose Surgical treatment of tibial plateau fracture (TPF) is common. Surgical site infections (SSI) are among the most serious complications of TPF. This multicentre study aimed to evaluate the effect of fracturoscopy on the incidence of surgical site infections in patients with TPF. Methods We performed a retrospective multicentre study. All patients with an AO/OTA 41 B and C TPF from January 2005 to December 2014 were included. Patients were divided into three groups: those who underwent arthroscopic reduction and internal fixation (ARIF), and those who underwent open reduction and internal fixation (ORIF) with fracturoscopy, and those treated with ORIF without fracturoscopy. The groups were compared to assess the effect of fracturoscopy. We characterised our cohort and the subgroups using descriptive statistics. Furthermore, we fitted a logistic regression model which was reduced and simplified by a selection procedure (both directions) using the Akaike information criterion (AIC). From the final model, odds ratios and inclusive 95% confidence intervals were calculated. Results Overall, 52 patients who underwent fracturoscopy, 48 patients who underwent ARIF, and 2000 patients treated with ORIF were identified. The rate of SSI was 0% (0/48) in the ARIF group and 1.9% (1/52) in the fracturoscopy group compared to 4.7% (93/2000) in the ORIF group (OR = 0.40, p = 0.37). Regression analyses indicated a potential positive effect of fracturoscopy (OR, 0.65; 95% CI, 0.07–5.68; p = 0.69). Conclusion Our study shows that fracturoscopy is associated with reduced rates of SSI. Further studies with larger cohorts are needed to investigate this. Level of evidence Level III.

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