RESUMEN
PURPOSE OF THE STUDY: The objective of this study is to evaluate the effect of posterior tibial slope after fracture healing on antero-posterior knee laxity, functional outcome and patient satisfaction. MATERIAL AND METHODS: 126 patients who were treated for tibial plateau fractures between 2008-2013 in the orthopedics and traumatology department of our institution were evaluated for the study. Patients were treated with open reduction and internal fixation, arthroscopy assisted minimally invasive osteosynthesis or conservative treatment. RESULTS: Mean posterior tibial slope after the treatment was 6.91 ± 5.11 and there was no significant difference when compared to the uninvolved side 6.42 ± 4,21 (p = 0.794). Knee laxity in anterior-posterior plane was 6.14 ± 2.11 and 5.95 ± 2.25 respectively on healthy and injured side. The difference of mean laxity in anterior-posterior plane between two sides was statistically significant. DISCUSSION: In this study we found no difference in laxity between the injured and healthy knees. However Tegner score decreased significantly in patients who had greater laxity difference between the knees. We did not find significant difference between fracture type and laxity, IKDC functional scores independent of the ligamentous injury. CONCLUSION: In conclusion despite coronal alignment is taken into consideration in treatment of tibial plateau fractures, sagittal alignment is reasonably important for stability and should not be ignored.
Asunto(s)
Fijación Interna de Fracturas/métodos , Inestabilidad de la Articulación/cirugía , Articulación de la Rodilla/fisiopatología , Tibia/anatomía & histología , Fracturas de la Tibia/cirugía , Adulto , Anciano , Artroscopía/métodos , Femenino , Humanos , Traumatismos de la Rodilla/cirugía , Articulación de la Rodilla/cirugía , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Estudios Retrospectivos , Tibia/diagnóstico por imagen , Fracturas de la Tibia/fisiopatología , Resultado del TratamientoRESUMEN
In literature cervical disc extrusions are considered by most neurosurgeons a definitive indication for surgery. This approach may stem from a fear of disc fragment migration with neurological deterioration. We report a rare case of cervical disc sequestration with a seldom prognosis which resolved spontaneously in a two-month follow-up on magnetic resonance imaging (MRI), emphasizing the efficacy and applicability of conservative treatment in cervical disc herniations. Even with the basic conservative treatment methods we observed the prominent decrease in symptoms and spontaneous total resorption of the sequestered fragment. Conservative treatment in sequestered cervical discs with no neurological deficit can be an alternative therapeutic approach with the guidance of MRI.