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Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates

BACKGROUND: Dual plate fixation in comminuted bicondylar tibial plateau fractures remains controversial. Open reduction and internal fixation, specifically through compromised soft tissues, has historically been associated with major wound complications. Alternate methods of treatment have been desc...

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Autores principales: Prasad, G Thiruvengita, Kumar, T Suresh, Kumar, R Krishna, Murthy, Ganapathy K, Sundaram, Nandkumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3654470/
https://www.ncbi.nlm.nih.gov/pubmed/23682182
http://dx.doi.org/10.4103/0019-5413.108915
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author Prasad, G Thiruvengita
Kumar, T Suresh
Kumar, R Krishna
Murthy, Ganapathy K
Sundaram, Nandkumar
author_facet Prasad, G Thiruvengita
Kumar, T Suresh
Kumar, R Krishna
Murthy, Ganapathy K
Sundaram, Nandkumar
author_sort Prasad, G Thiruvengita
collection PubMed
description BACKGROUND: Dual plate fixation in comminuted bicondylar tibial plateau fractures remains controversial. Open reduction and internal fixation, specifically through compromised soft tissues, has historically been associated with major wound complications. Alternate methods of treatment have been described, each with its own merits and demerits. We performed a retrospective study to evaluate the functional outcome of lateral and medial plate fixation of Schatzker type V and VI fractures through an anterolateral approach, and a medial minimally invasive approach or a posteromedial approach. MATERIALS AND METHODS: We treated 46 tibial plateau fractures Schatzker type V and VI with lateral and medial plates through an anterolateral approach and a medial minimal invasive approach over an 8 years period. Six patients were lost to followup. Radiographs in two planes were taken in all cases. Immediate postoperative radiographs were assessed for quality of reduction and fixation. The functional outcome was evaluated according to the Oxford Knee Score criteria on followup. RESULTS: Forty patients (33 men and 7 women) who completed the followup were included in the study. There were 20 Schatzker type V fractures and 20 Schatzker type VI fractures. The mean duration of followup was 4 years (range 1-8 years). All patients had a satisfactory articular reduction defined as ≤2 mm step-off or gap as assessed on followup. All patients had a good coronal and sagittal plane alignment, and articular width as assessed on supine X-rays of the knee in the anteroposterior (AP) and lateral views. The functional outcome, as assessed by the Oxford Knee Score, was excellent in 30 patients and good in 10 patients. All patients returned to their pre-injury level of activity and employment. There were no instances of deep infection. CONCLUSIONS: Dual plate fixation of severe bicondylar tibial plateau fractures is an excellent treatment option as it provides rigid fixation and allows early knee mobilization. Careful soft tissue handling and employing minimal invasive techniques minimizes soft tissue complications.
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spelling pubmed-36544702013-05-16 Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates Prasad, G Thiruvengita Kumar, T Suresh Kumar, R Krishna Murthy, Ganapathy K Sundaram, Nandkumar Indian J Orthop Original Article BACKGROUND: Dual plate fixation in comminuted bicondylar tibial plateau fractures remains controversial. Open reduction and internal fixation, specifically through compromised soft tissues, has historically been associated with major wound complications. Alternate methods of treatment have been described, each with its own merits and demerits. We performed a retrospective study to evaluate the functional outcome of lateral and medial plate fixation of Schatzker type V and VI fractures through an anterolateral approach, and a medial minimally invasive approach or a posteromedial approach. MATERIALS AND METHODS: We treated 46 tibial plateau fractures Schatzker type V and VI with lateral and medial plates through an anterolateral approach and a medial minimal invasive approach over an 8 years period. Six patients were lost to followup. Radiographs in two planes were taken in all cases. Immediate postoperative radiographs were assessed for quality of reduction and fixation. The functional outcome was evaluated according to the Oxford Knee Score criteria on followup. RESULTS: Forty patients (33 men and 7 women) who completed the followup were included in the study. There were 20 Schatzker type V fractures and 20 Schatzker type VI fractures. The mean duration of followup was 4 years (range 1-8 years). All patients had a satisfactory articular reduction defined as ≤2 mm step-off or gap as assessed on followup. All patients had a good coronal and sagittal plane alignment, and articular width as assessed on supine X-rays of the knee in the anteroposterior (AP) and lateral views. The functional outcome, as assessed by the Oxford Knee Score, was excellent in 30 patients and good in 10 patients. All patients returned to their pre-injury level of activity and employment. There were no instances of deep infection. CONCLUSIONS: Dual plate fixation of severe bicondylar tibial plateau fractures is an excellent treatment option as it provides rigid fixation and allows early knee mobilization. Careful soft tissue handling and employing minimal invasive techniques minimizes soft tissue complications. Medknow Publications & Media Pvt Ltd 2013 /pmc/articles/PMC3654470/ /pubmed/23682182 http://dx.doi.org/10.4103/0019-5413.108915 Text en Copyright: © Indian Journal of Orthopaedics http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Prasad, G Thiruvengita
Kumar, T Suresh
Kumar, R Krishna
Murthy, Ganapathy K
Sundaram, Nandkumar
Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates
title Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates
title_full Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates
title_fullStr Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates
title_full_unstemmed Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates
title_short Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates
title_sort functional outcome of schatzker type v and vi tibial plateau fractures treated with dual plates
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3654470/
https://www.ncbi.nlm.nih.gov/pubmed/23682182
http://dx.doi.org/10.4103/0019-5413.108915
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