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Clinico-radiological study of surgical treatment of tibial plateau fractures


Autoři: Rajendra Jagannath 1;  Harshith Neelaraju 2;  Padmanabhan Kumar Ashok 3;  Eapen Arun 4
Působiště autorů: Bengaluru, Karnataka, India ;  Department of Orthopaedics, Akash Institute of Medical Sciences And Research Centre, Bengaluru, India 1;  Department of Orthopaedics, Sapthagiri Institute of Medical Sciences And Research Centre, Bangaluru, India 2;  Department of Orthopaedics, Ramaiah medical College hospital, Bengaluru, India 3;  Ramaiah Medical College Hospital 4
Vyšlo v časopise: Clinical Osteology 2022; 27(1): 6-12
Kategorie: Původní články

Souhrn

Background: Locking compression plate (LCP) systems are beneficial for treating proximal tibial fractures as they combine the benefits of external and internal fixators, providing greater stability, vascular preservation, superior healing, and fewer complications. However, the translation of these properties to functional benefits for patients remains to be elucidated. Aims: To evaluate the clinical outcomes of tibial plateau fractures (TPFs) treated by LCP and by a combination of posterior and anterior lateral approaches. Methods: This prospective study enrolled 34 patients aged > 18 years, from both genders, with TPFs (Schatzker type 4, 5, 6.) Patients were treated with minimally invasive percutaneous plate osteosynthesis (MIPPO) or open reduction and internal fixation (ORIF) by LCP. They were followed up at 6 weeks, 3 months and 6 months postoperatively. Treatment results were assessed using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results were statistically analyzed using chi-square test and Wilcoxon signed rank test. p ≤ 0.05 indicated statistical significance. Results: With a mean age of 39.29 ± 8.85 years and M:F of 33:1, most patients showed Schatzkers type VI fractures (82.35 %). Anterolateral approach was most used (73.53 %). Most patients achieved good results (44.12 %), showing healing within 14–20 weeks. No association was found between age-group and Schatzkers type (p > 0.05). A significant post-operative reduction in WOMAC scores was noted for total as well as component (pain, stiffness, functional limitation) scores (p < 0.001). Conclusion: LCP is associated with significant improvements in patient’s experience of pain, stiffness and functional limitations.


Zdroje

1. Kim JW, Oh CW, Jung JW et al. Minimally Invasive Plate Osteosynthesis for Open Fractures of the Proximal Tibia. Clin Orthop Surg 2012; 4(49): 313–320. Available from DOI: <http://dx.doi.org/10.4055/cios.2012.4.4.313>.

2. Wennergren D, Bergdahl C, Ekelund J et al. Epidemiology and incidence of tibia fractures in the Swedish Fracture Register. Injury 2018; 49(11): 2068–2074. Available from DOI: <http://dx.doi.org/10.1016/j.injury.2018.09.008>.

3. Koval KJ, Helfet DL. Tibial Plateau Fractures: Evaluation and Treatment. J Am Acad Orthop Surg 1995; 3(2): 86–94. Available from DOI: <http://dx.doi.org/10.5435/00124635–199503000–00004>.

4. Elsoe R, Larsen P, Nielsen NP et al. Population-Based Epidemiology of Tibial Plateau Fractures. Orthopedics 2015; 38(9): e780– e786. Available from DOI: <http://dx.doi.org/10.3928/01477447–20150902–55>.

5. Court-Brown CM, McBirnie J. The epidemiology of tibial fractures. J Bone Joint Surg Br 1995; 77(3): 417–421.

6. Sommer C, Gautier E, Müller M et al. First clinical results of the Locking Compression Plate (LCP). Injury 2003; 34(Suppl 2): B43-B54. Available from DOI: <http://dx.doi.org/10.1016/j.injury.2003.09.024>.

7. Burdin G. Arthroscopic management of tibial plateau fractures: surgical technique. Orthop Traumatol Surg Res 2013; 99(Suppl 1): S208- S218. Available from DOI: <http://dx.doi.org/10.1016/j.otsr.2012.11.011>.

8. Saikia K, Bhuyan S, Bhattacharya T et al. Internal fixation of fractures of both bones forearm: Comparison of locked compression and limited contact dynamic compression plate. Indian J Orthop 2011; 45(5): 417–421. Available from DOI: <http://dx.doi.org/10.4103/0019–5413.83762>.

9. Stoffel K, Dieter U, Stachowiak G et al. Biomechanical testing of the LCP--how can stability in locked internal fixators be controlled? Injury 2003; 3 4(Suppl 2): B11-B19. Available from DOI: <http://dx.doi.org/10.1016/j.injury.2003.09.021>.

10. Vasanad GH, Antin SM, Akkimaradi RC et al. Surgical management of tibial plateau fractures – a clinical study. J Clin Diagn Res 2013; 7(12): 3128–3130. Available from DOI: <http://dx.doi.org/10.7860/JCDR/2013/7249.3894>.

11. Schatzker J, McBroom R, Bruce D. The tibial plateau fracture. The Toronto experience 1968--1975. Clin Orthop Relat Res 1979; 138: 94– 104.

12. Schatzker J. Fractures of the tibial plateau. In: Schatzker J, Tile M (eds.) The rationale of operative fracture care. 3rd ed. Springer: New York 2005: 447–469. ISBN 9783540228509. Available from DOI: <https://doi.org/10.22271/ortho.2021.v7.i2d.2644>.

13. Bellamy N, Buchanan WW, Goldsmith CH et al. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 1988; 15(12): 1833–1840.

14. Rolfson O, Bohm E, Franklin P et al. [Patient-Reported Outcome Measures Working Group of the International Society of Arthroplasty Registries]. Patient-reported outcome measures in arthroplasty registries Report of the Patient-Reported Outcome Measures Working Group of the International Society of Arthroplasty Registries Part II. Recommendations for selection, administration, and analysis. Acta Orthop 2016; 87(Suppl 1): 9–23. Available from DOI: <http://dx.doi.org/10.1080/17453674.2016.1181816>.

15. Bellamy N. Outcome measurement in osteoarthritis clinical trials. J Rheumatol Suppl 1995; 43: 49–51.

16. Tang X, Liu L, Tu CQ et al. Timing of internal fixation and effect on Schatzker IV-VI tibial plateau fractures. Chin J Traumatol 2012; 15(2): 81–85.

17. Prasad GT, Kumar TS, Kumar RK et al. Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates. Indian J Orthop 2013; 47(2): 188–194. Available from DOI: <http://dx.doi.org/10.4103/0019–5413.108915>.

18. Smith WR, Ziran BH, Anglen JO et al. Locking plates: tips and tricks. J Bone Joint Surg Am 2007; 89(10): 2298–2307. Available from DOI: <http://dx.doi.org/10.2106/00004623–200710000–00028>.

19. Märdian S, Landmann F, Wichlas F et al. Outcome of angular stable locking plate fixation of tibial plateau fractures Midterm results in 101 patients. Indian J Orthop 2015; 49(6): 620–629. Available from DOI: <http://dx.doi.org/10.4103/0019–5413.168755>.

20. Shiva NR, Ganesh P, Subbiah et al. Surgical management of closed fractures of distal end of femur or proximal end of tibia using locking compression plate: A prospective study. J Evol Med Dent Sci 2015; 4(26): 4479–4490. Available from DOI: <http://dx.doi.org/10.14260/jemds/2015/647>.

21. Jain JK, Asif N, Ahmad S et al. Locked compression plating for periand intra-articular fractures around the knee. Orthop Surg 2013; 5(4): 255–260. Available from DOI: <http://dx.doi.org/10.1111/os.12069>.

22. Patil DG, Ghosh S, Chaudhuri A et al. Comparative study of fixation of proximal tibial fractures by nonlocking buttress versus locking compression plate. Saudi J Sports Med 2015; 15(2): 142–147. Available from DOI: <http://dx.doi.org/10.4103/1319–6308.156345>.

Štítky
Biochemie Dětská gynekologie Dětská radiologie Dětská revmatologie Endokrinologie Gynekologie a porodnictví Interní lékařství Ortopedie Praktické lékařství pro dospělé Radiodiagnostika Rehabilitační a fyzikální medicína Revmatologie Traumatologie Osteologie

Článek vyšel v časopise

Clinical Osteology

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