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Multi-plate reconstruction for severe bicondylar tibial plateau fractures of young adults

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Abstract

Purpose

This study was to evaluate clinical outcomes and complications following multi-plate reconstruction for treating severe bicondylar tibial plateau fractures of young adults.

Methods

Between September 2007 and February 2012, 26 patients with severe bicondylar tibial plateau fractures met inclusion criteria; they were treated using multi-plate technique through combined approaches. Patients received an average follow-up of 40.8 (range, 18–64) months, which included anteroposterior and lateral imaging, postoperative complications, range of motion and stability of the knee. The Rasmussen score was applied for functional and radiological evaluation.

Results

Three to five plates were used for reconstruction. No intra-operative complications occurred. Postoperative complications included bulge of hardware in four patients and superficial dehiscence in three cases in the anterolateral incision of which one developed to deep infection. There was no neurovascular damage, and no implant breakage or loosening. Hardware was removed partly or totally in 16 cases. The average Rasmussen score at final follow-up was 27.2 (range, 21–30) points for functional evaluation and 16.4 (range, 14–18) for radiology.

Conclusions

Multi-plate reconstruction is a valid and safe method for treating severe bicondylar tibial plateau fractures of young adults.

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References

  1. Eggli S, Hartel MJ, Kohl S, Haupt U, Exadaktylos AK, Röder C (2008) Unstable bicondylar tibial plateau fractures: a clinical investigation. J Orthop Trauma 22(10):673–679. doi:10.1097/BOT.0b013e31818b1452

    Article  PubMed  Google Scholar 

  2. Canadian Orthopaedic Trauma Society (2006) Open reduction and internal fixation compared with circular fixator application for bicondylar tibial plateau fractures. Results of a multicenter, prospective, randomized clinical trial. J Bone Joint Surg Am 88(12):2613–2623

    Article  Google Scholar 

  3. Kini SG, Sathappan SS (2013) Role of navigated total knee arthroplasty for acute tibial fractures in the elderly. Arch Orthop Trauma Surg 133(8):1149–1154. doi:10.1007/s00402-013-1792-8

    Article  PubMed  Google Scholar 

  4. Biggi F, Di Fabio S, D’Antimo C, Trevisani S (2010) Tibial plateau fractures: internal fixation with locking plates and the MIPO technique. Injury 41(11):1178–1182. doi:10.1016/j.injury.2010.08.001

    Article  CAS  PubMed  Google Scholar 

  5. Weil YA, Gardner MJ, Boraiah S, Helfet DL, Lorich DG (2008) Posteromedial supine approach for reduction and fixation of medial and bicondylar tibial plateau fractures. J Orthop Trauma 22(5):357–362. doi:10.1097/BOT.0b013e318168c72e

    Article  PubMed  Google Scholar 

  6. Barei DP, Nork SE, Mills WJ, Coles CP, Henley MB, Benirschke SK (2006) Functional outcomes of severe bicondylar tibial plateau fractures treated with dual incisions and medial and lateral plates. J Bone Joint Surg Am 88(8):1713–1721

    Article  PubMed  Google Scholar 

  7. Luo CF, Sun H, Zhang B, Zeng BF (2010) Three-column fixation for complex tibial plateau fractures. J Orthop Trauma 24(11):683–692. doi:10.1097/BOT.0b013e3181d436f3

    Article  PubMed  Google Scholar 

  8. Nikolaou VS, Tan HB, Haidukewych G, Kanakaris N, Giannoudis PV (2011) Proximal tibial fractures: early experience using polyaxial locking-plate technology. Int Orthop 35(8):1215–1221. doi:10.1007/s00264-010-1153-y

    Article  PubMed Central  PubMed  Google Scholar 

  9. Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, Prokuski L, Sirkin MS, Ziran B, Henley B, Audigé L (2007) Fracture and dislocation classification compendium 2007: orthopaedic trauma association classification, database and outcomes committee. J Orthop Trauma 21(10 Suppl):S1–S133

    Article  CAS  PubMed  Google Scholar 

  10. Schatzker J, McBroom R, Bruce D (1979) The tibial plateau fracture: the Toronto experience 1968–1975. Clin Orthop Relat Res 138:94–104

    PubMed  Google Scholar 

  11. Gustilo RB, Mendoza RM, Williams DN (1984) Problems in the management of type III (severe) open fractures: a new classification of type III open fractures. J Trauma 24:742–746

    Article  CAS  PubMed  Google Scholar 

  12. Tscherne H, Oestern HJ (1982) A new classification of soft-tissue damage in open and closed fractures. Unfallheilkunde 85:111–115

    CAS  PubMed  Google Scholar 

  13. Chang SM, Wang X, Zhou JQ, Huang YG, Zhu XZ (2012) Posterior coronal plating of bicondylar tibial plateau fractures through posteromedial and anterolateral approaches in a healthy floating supine position. Orthopedics 35(7):583–588. doi:10.3928/01477447-20120621-03

    Article  PubMed  Google Scholar 

  14. He X, Ye P, Hu Y, Huang L, Zhang F, Liu G, Ruan Y, Luo C (2013) A posterior inverted L-shaped approach for the treatment of posterior bicondylar tibial plateau fractures. Arch Orthop Trauma Surg 133(1):23–28. doi:10.1007/s00402-012-1632-2

    Article  PubMed  Google Scholar 

  15. Rasmussen PS (1973) Tibial condylar fractures: impairment of knee joint stability as an indication for surgical treatment. J Bone Joint Surg Am 55:1331–1350

    CAS  PubMed  Google Scholar 

  16. Prasad GT, Kumar TS, Kumar RK, Murthy GK, Sundaram N (2013) Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates. Indian J Orthop 47(2):188–194. doi:10.4103/0019-5413.108915

    Article  PubMed Central  PubMed  Google Scholar 

  17. Weaver MJ, Harris MB, Strom AC, Smith RM, Lhowe D, Zurakowski D, Vrahas MS (2012) Fracture pattern and fixation type related to loss of reduction in bicondylar tibial plateau fractures. Injury 43(6):864–869. doi:10.1016/j.injury.2011.10.035

    Article  PubMed  Google Scholar 

  18. Barei DP, O’Mara TJ, Taitsman LA, Dunbar RP, Nork SE (2008) Frequency and fracture morphology of the posteromedial fragment in bicondylar tibial plateau fracture patterns. J Orthop Trauma 22(3):176–182. doi:10.1097/BOT.0b013e318169ef08

    Article  PubMed  Google Scholar 

  19. Weigel DP, Marsh JL (2002) High-energy fractures of the tibial plateau. Knee function after longer follow-up. J Bone Joint Surg Am 84-A:1541–1551

    PubMed  Google Scholar 

  20. Honkonen SE (1994) Indications for surgical treatment of tibial condyle fractures. Clin Orthop 302:199–205

    PubMed  Google Scholar 

  21. Sun H, Luo CF, Yang G, Shi HP, Zeng BF (2013) Anatomical evaluation of the modified posterolateral approach for posterolateral tibial plateau fracture. Eur J Orthop Surg Traumatol 23(7):809–818. doi:10.1007/s00590-012-1067-z

    Article  PubMed  Google Scholar 

  22. Heidari N, Lidder S, Grechenig W, Tesch NP, Weinberg AM (2013) The risk of injury to the anterior tibial artery in the posterolateral approach to the tibia plateau: a cadaver study. J Orthop Trauma 27(4):221–225. doi:10.1097/BOT.0b013e318271f8f0

    Article  PubMed  Google Scholar 

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Correspondence to Congfeng Luo.

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Zhai, Q., Hu, C. & Luo, C. Multi-plate reconstruction for severe bicondylar tibial plateau fractures of young adults. International Orthopaedics (SICOT) 38, 1031–1035 (2014). https://doi.org/10.1007/s00264-013-2211-z

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  • DOI: https://doi.org/10.1007/s00264-013-2211-z

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