Subdivision of injured area for Schatzker IV tibial plateau fracture repair: A report of 12 cases.

BACKGROUND: Treatment of Schatzker IV tibial plateau fractures is challenging due to the wide variety of potential fracture morphologies and injury to multiple ligaments. Subdivision of the injured area into three zones may simplify the preoperative plan. In this study, we reported 12 cases of Schatzker IV tibial plateau fracture that were treated with pre-operative plans based on a new subdivision of the injured area. METHODS: From January 2012 to April 2016, 12 patients with a Schatzker IV tibial plateau fracture were treated in our hospital with preoperative plans guided by the new sub-division method. Clinical and radiological results were evaluated during follow-up. RESULTS: In all cases, the incisions healed without skin necrosis, and the average Lysholm knee score was 73 points (range, 53-90) at the final follow-up. CONCLUSION: Sub-division of the injured area represented a useful strategy for preoperative surgical planning in the treatment of Schatzker IV tibial plateau fractures.

[Comparison of double titanium plate and clavicular hook plate for the treatment of Neer II distal clavicular fracture].

OBJECTIVE: To compare clinical efficacy of double titanium plate and clavicular hook plate for the treatment of Neer II distal clavicular fracture. METHODS: From April 2013 to June 2015, 42 patients with Neer II distal clavicle fractures were non-randomly selected, including 25 males and 17 females. All patients were fresh closed fractures. Twenty patients were treated with double titanium plate with tight rope(group A), including 11 males and 9 females aged from 16 to 49 years old with an average age of(33.8±10.7) years;the time from injury to operation ranged from 2 to 5 days with an average of (3.5±1.8) days. Twenty-two patients were treated with clavicle hook plate(group B), including 14 males and 8 females aged from 27 to 53 years old with an average age of (37.7±9.9) years;the time from injury to operation ranged from 2 to 5 days with an average of (3.1±2.0) days. Operative time, blood loss, hospital stays and postoperative complications were observed and compared; fracture healing were compared among preoperative, postoperative at 1, 3 and 6 months; VAS and ASES scoring were used to evaluate shoulder function. RESULTS: All patients were followed up from 6 to 12 months with an average of 7.2 months. All incisions were healed at stage I. Blood loss in group A were less than that of group B(P<0.05); while there were no significant difference in hospital stays and operative time between two groups. No shoulder pain occurred in group A, 4 cases occurred shoulder pain in group B, and had significant difference. Fracture healing time ranged from 3 to 6 months with an average of 4.3 months. VAS score and ASES score in group A were higher than that of group B in pain, function and total score. CONCLUSIONS: Compared with clavicle hook plate, double titanium plate has advantages of shorter incision wound, less bleeding and simply operation, less complications, and could avoid pain for removing internal fixation. Over reduction of acromioclavicular joint during operation does not affect its superior curative effect. It is better choice for the treatment of Neer II distal clavicle fracture.