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OBJECTIVE: To compare postoperative radiographic outcomes of Schatzker type V and VI tibial plateau fractures treated with double-plate or single lateral locked plate. METHODS: Sixty-three patients operated from December 2011 to February 2016 were selected, 47 from the double-plate group and 16 from the single lateral locked plate group. Minimum follow-up for all patients was 6 months. Fracture reduction evaluation was based on radiographic parameters: joint reduction, sagittal alignment, coronal alignment, and condylar width. RESULTS: Radiographic evaluation showed no statistical difference in the immediate or late postoperative periods. CONCLUSION: Despite the reduced sample, this study is aligned with current results published in the medical literature. The severity of Schatzker type V and VI tibial plateau fractures can be minimized by the correct indication for the implant regarding fracture morphology. Level of Evidence III, Retrospective comparative study.
OBJETIVO: Comparar desfechos radiográficos pós-operatórios de fraturas do planalto tibial Schatzker V e VI tratados com dupla placa ou placa bloqueada única lateral. MÉTODOS: Foram selecionados 63 pacientes operados no período de dezembro de 2011 a fevereiro de 2016, sendo 47 do grupo dupla placa e 16 do grupo placa bloqueada lateral única. Todos os pacientes tiveram seguimento mínimo de seis meses. A avaliação da redução das fraturas foi baseada nos parâmetros radiográficos: redução articular, alinhamento sagital, alinhamento coronal e largura condilar. RESULTADOS: A avaliação radiográfica não demonstrou diferença estatística no pós-operatório imediato nem no tardio. CONCLUSÃO: Apesar da amostra reduzida, o estudo vai ao encontro dos resultados mais atuais publicados na literatura médica. A gravidade das fraturas do planalto tibial Shatzker V e VI pode ser minimizada com a correta indicação do implante segundo a morfologia da fratura. Nível de Evidência III, Estudo retrospectivo comparativo.
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ABSTRACT Objective: To compare postoperative radiographic outcomes of Schatzker type V and VI tibial plateau fractures treated with double-plate or single lateral locked plate. Methods: Sixty-three patients operated from December 2011 to February 2016 were selected, 47 from the double-plate group and 16 from the single lateral locked plate group. Minimum follow-up for all patients was 6 months. Fracture reduction evaluation was based on radiographic parameters: joint reduction, sagittal alignment, coronal alignment, and condylar width. Results: Radiographic evaluation showed no statistical difference in the immediate or late postoperative periods. Conclusion: Despite the reduced sample, this study is aligned with current results published in the medical literature. The severity of Schatzker type V and VI tibial plateau fractures can be minimized by the correct indication for the implant regarding fracture morphology. Level of Evidence III, Retrospective comparative study.
RESUMO Objetivo: Comparar desfechos radiográficos pós-operatórios de fraturas do planalto tibial Schatzker V e VI tratados com dupla placa ou placa bloqueada única lateral. Métodos: Foram selecionados 63 pacientes operados no período de dezembro de 2011 a fevereiro de 2016, sendo 47 do grupo dupla placa e 16 do grupo placa bloqueada lateral única. Todos os pacientes tiveram seguimento mínimo de seis meses. A avaliação da redução das fraturas foi baseada nos parâmetros radiográficos: redução articular, alinhamento sagital, alinhamento coronal e largura condilar. Resultados: A avaliação radiográfica não demonstrou diferença estatística no pós-operatório imediato nem no tardio. Conclusão: Apesar da amostra reduzida, o estudo vai ao encontro dos resultados mais atuais publicados na literatura médica. A gravidade das fraturas do planalto tibial Shatzker V e VI pode ser minimizada com a correta indicação do implante segundo a morfologia da fratura. Nível de Evidência III, Estudo retrospectivo comparativo.
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@#ObjectiveTo investigate methods of early postoperative rehabilitation and its effects on patients with bicondylar tibial plateau fracture treated by modified dual plating.Methods66 patients with bicondylar tibial plateau fracture from Tianjin Hospital were divided into 2 groups according to the starting time for postoperative rehabilitation: early rehabilitation group (n=30), convalescents rehabilitation group (n=36). The two groups had the same treatment since the fourth week postoperative. Tibial plateau angle (TPA) and posterior slope angle (PA) of tibial plateau were measured to evaluate the stability of proximal tibial and knee alignment. The Hospital for Special Surgery (HSS) score system and knee joint range of motion (ROM) were used as the parameters for knee function.ResultsThe mean value of TPA and PA had no significant changes, compared to the final follow-up and postoperative X-ray films(P>0.05); the differences between the two groups were statistically significant in the mean HSS score and mean value of knee flexion and extention ROM(P<0.01 or 0.05). There was significantly positive correlation between starting time and the total number of treatment was significant(P<0.01), while negative correlation with flexion ROM of knee joint and the HSS score(P<0.01).ConclusionThe correlation between rehabilitation intervention timing and functional recovery for patients with bicondylar tibial plateau fracture treated by modified dual plating is significant, early individual and systematic rehabilitation therapy can effectively improve the prognosis features of patients.
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[Objective]To analyze the results of distal tibial pilon fractures treated with individual management based on severity of soft tissue injury.[Method]From January 2005 to September 2008,29 Pilon fractures were treated.There were 22 males and 7 females aging from 23 to 63,with an average of 41.4.According to Ruedi-Allgower classification system of Pilon fracture,16 cases were type Ⅱ,13 type Ⅲ.According to Tscherne-Gotzen graduation system of soft tissue injury,22 cases were close fracture,8 grade 0,4 grade 1,8 grade 2,2 grade 3,and 7 cases were open fracture,3 grade 1,2 grade 2,2 grade 3.Individual management was based on severity of soft tissue injury.[Result]All patients were available for follow-up at an average of 28.6 months(range,12 to 56 months) after surgery.There were 10 excellent,13 good,4 fair,and 2 poor results according to the ankle score of Mazur.The complications occurred in 5 patients(17.2%),including wound superficial infection(n=2),skin necrosis(n=1),deep infection(n=1),and pin tract infection(n=1) with external fixation.[Conclusion]Individual management based on severity of soft tissue injury for Pilon fracture has advantages of fewer complications and good function.