Abstract
The treatment of intra-articular proximal tibial fractures is associated with complications, and much conflicting literature exists concerning the treatment of choice. In our study, an attempt has been made to develop an ideal and adequate treatment protocol for these intra-articular fractures. The principle of double osteosynthesis, i.e., lateral minimally invasive plate osteosynthesis (MIPO), was combined with a medial external fixator to treat 22 intra-articular proximal tibial fractures with soft tissue injury with a mean follow-up of 25 months. Superficial pin track infection was observed in one case, and no soft tissue breakdown was noted. Loss of articular reconstruction was reported in one case. Bridging callus was seen at 12 weeks (8 weeks–7 months). The principle of substitution or double osteosynthesis, i.e., lateral MIPO, was combined with a medial external fixator and proved to be a fairly good method of fixation in terms of results and complications.
Résumé
le traitement des fractures articulaires du tibia proximal est associé à un certain nombre de complications. Les traitements sont multiples. Dans notre étude, nous avons souhaité nous diriger vers un protocole adapté à ces fractures intra articulaires. le principe d’une double ostéosynthèse, c’est-à-dire, ostéosynthèse latérale par voie mini invasive, à l’aide d’une plaque (MIPO) a été combinée avec un fixateur externe par voie interne. 22 patients présentant une telle lésion ont été traités de cette façon avec un suivi moyen de 25 mois. des infections de broches superficielles ont été observées dans un cas sans lésion notable des tissus mous. Un déplacement secondaire articulaire a également été rapporté dans un cas. L’apparition d’un pont osseux se fait généralement à 12 semaines en moyenne (huit semaines à sept mois). le principe d’un tel traitement avec double ostéosynthèse est une bonne méthode pour traiter ces lésions et pour éviter un certain nombre de complications.
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Singh, S., Patel, P.R., Joshi, A.K. et al. Biological approach to treatment of intra-articular proximal tibial fractures with double osteosynthesis. International Orthopaedics (SICO 33, 271–274 (2009). https://doi.org/10.1007/s00264-007-0480-0
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DOI: https://doi.org/10.1007/s00264-007-0480-0