Surgical Management of Tibial Plateau Fractures With 3.5 Mm Simple Plates

Overview

Journal Trauma Mon

Specialty Emergency Medicine

Date 2016 Sep 15

PMID 27626010

Citations 4

Authors

Abolfazl Bagherifard

Mahmoud Jabalameli

Hosseinali Hadi

Mohammad Rahbar

Mohammadreza Minator Sajjadi

Ali Jahansouz

Hossein Karimi Heris

Affiliations

Soon will be listed here.

Abstract

Background: Tibial plateau fractures can be successfully fixed utilizing 3.5 mm locking plates. However, there are some disadvantages to using these plates.

Objectives: In the current prospective study, we investigated the outcome of treating different types of tibial plateau fractures with 3.5 mm simple plates which, to our knowledge, has not been evaluated in previous studies.

Materials And Methods: Between 2011 and 2013, 32 patients aged 40 ± 0.2 years underwent open reduction and internal fixation for tibial plateau fractures with 3.5 mm simple plates. The patients were followed for 16.14 ± 2.1 months. At each patient's final visit, the articular surface depression, medial proximal tibial angle, and slope angle were measured and compared with measurements taken early after the operation. The functional outcomes were measured with the WOMAC and Lysholm knee scores.

Results: The mean union time was 13 ± 1.2 weeks. The mean knee range of motion was 116.8° ± 3.3°. The mean WOMAC and Lysholm scores were 83.5 ± 1.8 and 76.8 ± 1.6, respectively. On the early postoperative and final X-rays, 87.5% and 84% of patients, respectively, had acceptable reduction. Medial proximal tibial and slope angles did not change significantly by the last visit. No patient was found to have complications related to the type of plate.

Conclusions: In this case series study, the fixation of different types of tibial plateau fractures with 3.5 mm simple non-locking and non-precontoured plates was associated with acceptable clinical, functional, and radiographic outcomes. Based on the advantages and costs of these plates, the authors recommend using 3.5 mm simple plates for different types of tibial plateau fractures.

Citing Articles

The Comparison Between 3.5- and 4.5-mm T-plates for Management of the Patients with Schatzker Type II Tibial Plateau Fractures that Referred to our Emergency Department: A Clinical Trial.

Parhamfar M, Mohammadsharifi G, Taravati A, Hatami S, Sadeghian A, Khashei M Adv Biomed Res. 2023; 12:206.

PMID: 38073722 PMC: 10699211. DOI: 10.4103/abr.abr_40_23.

[Application of modified anterolateral supra-fibular-head approach in treatment of tibial plateau fractures involving posterolateral column].

Zu B, Wang J, Liu J, Chen Z Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020; 34(6):702-706.

PMID: 32538559 PMC: 8171541. DOI: 10.7507/1002-1892.201910010.

Prevalence of Deep Surgical Site Infection After Repair of Periarticular Knee Fractures: A Systematic Review and Meta-analysis.

Norris G, Checketts J, Scott J, Vassar M, Norris B, Giannoudis P JAMA Netw Open. 2019; 2(8):e199951.

PMID: 31441940 PMC: 6714463. DOI: 10.1001/jamanetworkopen.2019.9951.

[Effectiveness analysis of surgical treatment of Schatzker type tibial plateau fractures].

Yan B, Yin W, Zhang X, Liu D, Gui K, Sun J Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018; 31(11):1305-1310.

PMID: 29798582 PMC: 8632581. DOI: 10.7507/1002-1892.201704142.

References

Yoo B, Beingessner D, Barei D . Stabilization of the posteromedial fragment in bicondylar tibial plateau fractures: a mechanical comparison of locking and nonlocking single and dual plating methods. J Trauma. 2010; 69(1):148-55. DOI: 10.1097/TA.0b013e3181e17060. View

Karunakar M, Egol K, Peindl R, Harrow M, Bosse M, Kellam J . Split depression tibial plateau fractures: a biomechanical study. J Orthop Trauma. 2002; 16(3):172-7. DOI: 10.1097/00005131-200203000-00006. View

Lee J, Papadakis S, Moon C, Zalavras C . Tibial plateau fractures treated with the less invasive stabilisation system. Int Orthop. 2006; 31(3):415-8. PMC: 2267604. DOI: 10.1007/s00264-006-0176-x. View

Stannard J, Wilson T, Volgas D, Alonso J . The less invasive stabilization system in the treatment of complex fractures of the tibial plateau: short-term results. J Orthop Trauma. 2004; 18(8):552-8. DOI: 10.1097/00005131-200409000-00012. View

Krettek C, Gerich T, Miclau T . A minimally invasive medial approach for proximal tibial fractures. Injury. 2001; 32 Suppl 1:SA4-13. DOI: 10.1016/s0020-1383(01)00056-0. View

Egol K, Tejwani N, Capla E, Wolinsky P, Koval K . Staged management of high-energy proximal tibia fractures (OTA types 41): the results of a prospective, standardized protocol. J Orthop Trauma. 2005; 19(7):448-55. DOI: 10.1097/01.bot.0000171881.11205.80. View

Yoon Y, Oh J, Oh C, Sahu D, Hwang J, Cho J . Inside out rafting K-wire technique for tibial plateau fractures. Arch Orthop Trauma Surg. 2011; 132(2):233-7. DOI: 10.1007/s00402-011-1409-z. View

El Barbary H, Ghani H, Misbah H, Salem K . Complex tibial plateau fractures treated with Ilizarov external fixator with or without minimal internal fixation. Int Orthop. 2005; 29(3):182-5. PMC: 3456886. DOI: 10.1007/s00264-005-0638-6. View

Goyal K, Skalak A, Marcus R, Vallier H, Cooperman D . Analysis of anatomic periarticular tibial plate fit on normal adults. Clin Orthop Relat Res. 2007; 461:245-57. DOI: 10.1097/BLO.0b013e31809e6e45. View

10.

Baima J, Krivickas L . Evaluation and treatment of peroneal neuropathy. Curr Rev Musculoskelet Med. 2009; 1(2):147-53. PMC: 2684217. DOI: 10.1007/s12178-008-9023-6. View

11.

Kaab M, Frenk A, Schmeling A, Schaser K, Schutz M, Haas N . Locked internal fixator: sensitivity of screw/plate stability to the correct insertion angle of the screw. J Orthop Trauma. 2004; 18(8):483-7. DOI: 10.1097/00005131-200409000-00002. View

12.

Chin T, Bardana D, Bailey M, Williamson O, Miller R, Edwards E . Functional outcome of tibial plateau fractures treated with the fine-wire fixator. Injury. 2005; 36(12):1467-75. DOI: 10.1016/j.injury.2005.05.008. View

13.

Yu Z, Zheng L, Zhang Y, Li J, Ma B . Functional and radiological evaluations of high-energy tibial plateau fractures treated with double-buttress plate fixation. Eur J Med Res. 2009; 14(5):200-5. PMC: 3351978. DOI: 10.1186/2047-783x-14-5-200. View

14.

Greiwe R, Archdeacon M . Locking plate technology: current concepts. J Knee Surg. 2007; 20(1):50-5. DOI: 10.1055/s-0030-1248022. View

15.

Lasanianos N, Garnavos C, Magnisalis E, Kourkoulis S, Babis G . A comparative biomechanical study for complex tibial plateau fractures: nailing and compression bolts versus modern and traditional plating. Injury. 2013; 44(10):1333-9. DOI: 10.1016/j.injury.2013.03.013. View

16.

Westmoreland G, McLaurin T, Hutton W . Screw pullout strength: a biomechanical comparison of large-fragment and small-fragment fixation in the tibial plateau. J Orthop Trauma. 2002; 16(3):178-81. DOI: 10.1097/00005131-200203000-00007. View

17.

Young M, Barrack R . Complications of internal fixation of tibial plateau fractures. Orthop Rev. 1994; 23(2):149-54. View

18.

DeCoster T, Nepola J, El-Khoury G . Cast brace treatment of proximal tibia fractures. A ten-year follow-up study. Clin Orthop Relat Res. 1988; (231):196-204. View

19.

Sament R, Mayanger J, Tripathy S, Sen R . Closed reduction and percutaneous screw fixation for tibial plateau fractures. J Orthop Surg (Hong Kong). 2012; 20(1):37-41. DOI: 10.1177/230949901202000108. View

20.

Smith W, Ziran B, Anglen J, Stahel P . Locking plates: tips and tricks. J Bone Joint Surg Am. 2007; 89(10):2298-307. DOI: 10.2106/00004623-200710000-00028. View