EVALUATION OF OUTCOMES IN TREATING CLOSED POSTERIOR TIBIAL PLATEAU FRACTURES USING OPEN REDUCTION INTERNAL FIXATION
Main Article Content
Abstract
Background: The tibial plateau fracture is a type of fracture related to the joint surface of the upper end of the tibia articulating with the distal end of the femur. Among them, the posterior column fracture of the tibial plateau occurs when a fall mechanism impacts the femoral condyle on the knee joint in a flexed position. Objectives: To assess the treatment outcomes of closed posterior tibial plateau fractures using open reduction and internal fixation method. Materials and methods: 33 cases of posterior tibial plateau fractures with three-dimensional CT scans were treated at Can Tho Central General Hospital and Can Tho University of Medicine and Pharmacy Hospital from June 2022 to April 2024. Results: The study revealed 6 cases requiring bone grafting, accounting for 18.2%. Among the patients, 23 cases experienced varus force causing fractures on the medial tibial plateau (69.7%), while 10 cases experienced valgus force causing lateral tibial plateau (30.3%). Postoperative complications occurred in 2 cases (6.06%), including one case of common peroneal nerve injury and one case of superficial infection. After 3 months, 26 cases (78.8%) achieved good results, 6 cases (18.2%) achieved very good results, and 1 case (3%) achieved moderate functional recovery. At 6 months, all cases showed good to excellent functional recovery. Conclusion: The research provides many morphological tibial plateau fractures with 3D CT scans to support classifying the posterior tibial plateau fractures and assists the surgeon in selecting the most suitable surgical approach and optimizing bone fixation techniques tailored to each specific fracture type.
Article Details
Keywords
Posterior tibial plateau fractures, three-column classification, reverse L-shaped incision approach
References
2. Van den Berg J, De Boer A, Assink N, et al. Trauma mechanism and patient reported outcome in tibial plateau fractures with posterior involvement. The Knee. 2021. 30, 41-50, doi:10.1016/j.knee.2021.03.011.
3. Callary SA, Jones CF, Kantar K, et al. A new approach to surgical management of tibial plateau fractures. Journal of Clinical Medicine. 2020. 9(3), 626, doi:10.3390%2Fjcm9030626.
4. Sameer MM, Bassetty KC, Singaravadivelu V. Functional Outcome Analysis of Fixation of Tibial Plateau Fractures using the Three-column Concept. Journal of Orthopaedic Case Reports. 2022. 12(5), 6, doi:10.13107%2Fjocr.2022.v12.i05.2792.
5. Luo C-F, Sun H, Zhang B, Zeng B-FJJoot. Three-column fixation for complex tibial plateau fractures. Journal of Orthopaedic Trauma. 2010. 24(11), 683-692, doi:10.1097/BOT.0b013e3181d436f3.
6. Hua K, Jiang X, Zha Y, Chen C, Zhang B, Mao Y. Retrospective analysis of 514 cases of tibial plateau fractures based on morphology and injury mechanism. Journal of orthopaedic surgery and research. 2019. 14(1), 1-10, doi:10.1186/s13018-019-1321-8.
7. Hu Y, Peng A, Wang S, Pan S, Zhang XJOS. Flexion Tibial Plateau Fractures: 3‐dimensional CT Simulation‐based Subclassification by Injury Pattern. 2022. 14(3), 543-554, doi:10.1111/os.13190.
8. Cooper GM, Kennedy MJ, Jamal B, Shields DW. Autologous versus synthetic bone grafts for the surgical management of tibial plateau fractures: a systematic review and meta-analysis of randomized controlled trials. Bone & Joint Open. 2022. 3(3), 218-228, doi:10.1302/26331462.33.BJO-2021-0195.R1.
9. Wang Y, Luo C, Zhu Y, Zhai Q, Zhan Y, Qiu W, Xu Y. Updated three-column concept in surgical treatment for tibial plateau fractures–a prospective cohort study of 287 patients. Injury. 2016. 47(7), 1488-1496, doi:10.1016/j.injury.2016.04.026.
10. Gálvez-Sirvent E, Ibarzábal-Gil A, Rodríguez-Merchán EC. Complications of the surgical treatment of fractures of the tibial plateau: prevalence, causes, and management. EFORT Open Reviews. 2022. 7(8), 554-568, doi:10.1530/EOR-22-0004.
11. Rasmussen PS. Tibial condylar fractures: impairment of knee joint stability as an indication for surgical treatment. JBJS. 1973. 55(7), 1331-1350.