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Il ruolo della fissazione esterna nel trattamento delle fratture complesse della tibia prossimale

Role of external fixation in the treatment of complex tibial plateau fractures

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LO SCALPELLO-OTODI Educational

Abstract

Tibial plateau fractures represent an important chapter in traumatology, as they can produce joint and soft tissue damage. From 1999 to 2015, we treated 349 patients. The Schatzker classification was used to classify the lesion type. Tibial plateau fractures belonging to II, IV, V, and VI types were ostesynthetized by External Fixation (\(\mathit{EF}\)). We assessed the clinical outcome using the HOHL-LUCK table, whereas the radiological assessment was performed using Bernischke’s criteria. In most cases, we obtained good results and plateau fractures (80%) were reduced using a minimally invasive technique, respecting the damaged soft tissue, and leading to earlier mobilization and better recovery of the range of motion. Our study demonstrated that EF allows us to obtain excellent result by guaranteeing anatomical reduction of the articular surface, fragment stabilization and earlier mobilization. For this reason, EF represents a valuable method in the synthesis of complex tibial plateau fractures.

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Bibliografia

  1. Lobenhoffer P, Schulze M, Tscherne H (1996) Anatomic reduction and appropriate implant placement is essential for optimal treatment of intraarticular tibial plateau fractures. Minimally invasive osteosynthesis of fractures of the tibial head. Unfallchirurg 99:569–575

    CAS  PubMed  Google Scholar 

  2. McLaurin T (2005) Hybrid ring external fixation in the treatment of complex tibial plateau fractures. Tech Knee Surg 4:226–236

    Article  Google Scholar 

  3. Rosemeyer B, Pförringer W (1979) Basic principles of treatment in pseudarthroses and malunion of fracture of the leg. Arch Orthop Trauma Surg 95:57–64

    Article  CAS  PubMed  Google Scholar 

  4. Schatkzer (1979) The tibial plateau fracture: the Toronto experience. Clin Orthop 138:94–104

    Google Scholar 

  5. Connoly JF (2005) Closed reduction of tibial plateau fractures. A comparison of functional and roentgenographic end results. Clin Orthop 230:116–126

    Google Scholar 

  6. Ali AM, El-Shafie M, Willett KM (2002) Failure of fixation of tibial plateau fractures. J Orthop Trauma 1(5):323–329

    Article  Google Scholar 

  7. Stevens DG, Beharry R, McKee MD et al. (2001) The long-term functional outcome of operatively treated tibial plateau fractures. J Orthop Trauma 15(5):312–320

    Article  CAS  PubMed  Google Scholar 

  8. Mikulak SA, Gold SM, Zinar DM (1998) Small wire external fixation of high energy tibial plateau fractures. Clin Orthop Relat Res 356:230–238

    Article  Google Scholar 

  9. Berkson EM (2006) High-energy tibial plateau fractures. J Am Acad Orthop Surg 14(1):20–31

    Article  PubMed  Google Scholar 

  10. Jensen D, Rude C, Duus B, Bjerg-Nielsen A (1990) Tibial plateau fractures. A comparison of conservative and surgical treatment. J Bone Jt Surg, Br 72-B:49–52

    Article  Google Scholar 

  11. Babis GC, Evangelopoulos DS, Kontovazenitis P et al. (2011) High energy tibial plateau fractures treated with hybrid external fixation. J Orthop Surg Res 6:35

    Article  PubMed  PubMed Central  Google Scholar 

  12. Dendrinos GK, Kontos S, Katsenis D, Dalas A (1996) Treatment of high-energy tibial plateau fractures by the Ilizarov circular fixator. J Bone Jt Surg, Br 78-B:710–717

    Article  Google Scholar 

  13. Koval KJ, Helfet DL (1995) Tibial plateau fractures: evaluation and treatment. J Am Acad Orthop Surg 3:86–94

    Article  CAS  PubMed  Google Scholar 

  14. Dirschl DR, Del Gaizo D (2007) Staged management of tibial plateau fractures. Am J Orthop 36(4 Suppl):12–17

    PubMed  Google Scholar 

  15. Elgazzar AS, Mohamady EM, Kandil WA (2014) Management of comminuted tibial plateau fracture with external fixator using ligamentotaxis principle. Egypt Orthop J 49:167–173

    Article  Google Scholar 

  16. Rademakers MV, Kerkhoffs GM, Sierevelt IN et al. (2007) Operative treatment of 109 tibial plateau fractures: five- to 27-year follow-up results. J Orthop Trauma 21(1):5–10

    Article  CAS  PubMed  Google Scholar 

  17. Jensen D et al. (1992) Tibial plateau fractures: a comparison of conservative and surgical treatment. J Bone Jt Surg 72-B:49–52

    Article  Google Scholar 

  18. Subas M, Kapukaya A, Arslan H et al. (2007) Outcome of open comminuted tibial plateau fractures treated using an external fixator. J Orthop Sci 12:347–353

    Article  Google Scholar 

  19. Ramos T, Ekholm C, Eriksson BI et al. (2013) The ilizarov external fixator: a useful alternative for the treatment of proximal tibial fractures. a prospective observational study of 30 consecutive patients. BMC Musculoskelet Disord 14:11

    Article  PubMed  PubMed Central  Google Scholar 

  20. Rossi et al. (2006) An interesting technique using a combination of arthroscopy and fluoroscopy has been proposed

  21. Harris NL, Purnell ML, Pevny T, Larson AI (2007) Arthroscopic management of tibial plateau fractures. Tech Knee Surg 6(1):9–16

    Article  Google Scholar 

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Authors and Affiliations

  1. Dipartimento di Ortopedia, Ospedale Nesima Garibaldi, Catania, Italia

    P. Barbato & W. Leonardi

  2. Dipartimento di Ortopedia, Ospedale Civile, Ragusa, Italia

    E. Leonardi

Authors
  1. P. Barbato
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  2. E. Leonardi
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  3. W. Leonardi
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Correspondence to P. Barbato.

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Gli autori Pietro Barbato, Erika Leonardi e Walter Leonardi dichiarano di non aver alcun conflitto d’interesse.

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Tutte le procedure descritte nello studio e che hanno coinvolto esseri umani sono state attuate in conformità alle norme etiche stabilite dalla dichiarazione di Helsinki del 1975 e successive modifiche. Il consenso informato è stato ottenuto da tutti i pazienti inclusi nello studio.

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L’articolo non contiene alcuno studio eseguito su esseri umani e su animali da parte degli autori.

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Barbato, P., Leonardi, E. & Leonardi, W. Il ruolo della fissazione esterna nel trattamento delle fratture complesse della tibia prossimale. LO SCALPELLO 29, 111–116 (2015). https://doi.org/10.1007/s11639-015-0122-z

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