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Joint line plate fixation for tibial plateau fractures caused by hyperextension varus.

ABSTRACT: The present study evaluated the outcomes of internal fixation with a joint line plate in the treatment of tibial plateau fractures caused by hyperextension of the varus. The study included 25 cases (13 males and 12 females; age, 19-71 years) of tibial plateau fracture caused by hyperextension of the varus, which were treated at Puai Hospital, Tongji Medical College (Wuhan, China) between January 2015 and June 2017. Fractures were treated with internal fixations of the inner cortex with a self-clipped joint line plate made of steel. After the surgery, patients were examined immediately and at 3, 6 and 12 months. Healing was evaluated by X-ray examination. All cases were cured during follow-up. After surgery, one patient developed partial necrosis of the skin margin of the incision and recovered after a dressing change. Furthermore, one patient with a concomitant peroneal nerve injury and hypoesthesia recovered after treatment with neurotrophic drugs. No screw loosening, fractures or failure of the internal fixations occurred. According to the X-ray results, there were significant differences in the tibial plateau angle (TPA) and medial posterior slope angle (m-PSA) between the pre-operative stage and 12 months post-operatively (P<0.05). However, no significant differences in either the TPA or m-PSA were present between the immediate post-operative stage and 12 months post-operatively (P>0.05). In conclusion, internal fixation with a joint line plate is an appropriate treatment for tibial plateau fractures involving the anteromedial margin with good clinical efficacy.

SUBMITTER: Huang YC

PROVIDER: S-EPMC8082576 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundIn tibial plateau fractures, the posterolateral segment of the tibia plateau is frequently affected and challenging to treat. Although there are many surgical approaches and fixation methods for the treatment of these fractures, all of these methods have limitations. We designed a new rotational support plate (RSP) and a special pressurizer that can fix the fracture directly via the anterolateral approach. This method is advantageous because it leads to little trauma, involves a simple operation, and has a reliable fixation effect. This study details the technique of treating these fractures with the RSP and special pressurizer and provides the outcomes.MethodsFrom May 2016 to January 2019, the data of 12 patients with posterolateral tibial plateau fractures treated with the RSP and special pressurizer in our hospital were retrospectively analyzed. Postoperative rehabilitation was advised, knee X-rays were taken at follow-ups, and fracture healing, complications, and knee range of motion were assessed. The Hospital for Special Surgery (HSS) knee score and Knee Injury and Osteoarthritis Outcome Score (KOOS) were used to evaluate knee function at the last follow-up.ResultsThe average follow-up time of all patients was 16.5 months (range, 12-25 months). The average bony union time was 3.2 months (range, 3-4.5 months). At the last follow-up, the average knee range of motion was 138° (range, 107-145°). The average HSS score was 91 (range, 64-98). The average KOOS Symptoms score was 90 (range, 75-96). The average KOOS Pain score was 91 (range, 72-97). The average KOOS ADL score was 91 (range, 74-97). The average KOOS sport/recreation score was 83 (range, 70-90). The average KOOS QOL score was 88 (range, 69-93). Skin necrosis, incision infections, and fixation failure did not occur during the follow-up period.ConclusionsWith our newly designed RSP and special pressurizer, posterolateral tibial plateau fractures can be easily and effectively reduced and fixed through the anterolateral approach, which serves as a novel treatment for posterolateral tibial plateau fractures.

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Joint line plate fixation for tibial plateau fractures caused by hyperextension varus.

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