Lateral tibial plateau fractures-functional outcomes and complications after open reduction and internal fixation.

Autor: Milenkovic S; University of Nis, Medical faculty, Clinic for orthopaedic surgery and traumatology, Clinical Centre of Nis, Nis, Serbia. sasaortoped@gmail.com., Mitkovic M; University of Nis, Medical faculty, Clinic for orthopaedic surgery and traumatology, Clinical Centre of Nis, Nis, Serbia., Mitkovic M; Serbian Academy of Sciences and Arts (SANU), Belgrade, Serbia., Stojiljkovic P; University of Nis, Medical faculty, Clinic for orthopaedic surgery and traumatology, Clinical Centre of Nis, Nis, Serbia., Stojanovic M; University of Nis, Medical faculty, Clinic for orthopaedic surgery and traumatology, Clinical Centre of Nis, Nis, Serbia.
Jazyk: angličtina
Zdroj: International orthopaedics [Int Orthop] 2021 Apr; Vol. 45 (4), pp. 1071-1076. Date of Electronic Publication: 2020 Aug 01.
DOI: 10.1007/s00264-020-04763-y
Abstrakt: Purpose: Tibial plateau fractures are severe intra-articular injuries; their treatment is accompanied by numerous complications and requires extensive surgical experience. In this manuscript, we compared our experiences with data from the literature.
Methods: Retrospectively, we analyzed 41 patients with closed lateral tibial plateau fracture (Schatzker's I-III). All fractures were treated surgically with open reduction and internal plate fixation. Post-operative complications and final outcomes were monitored according to the Tegner Lysholm Knee Scoring System. The average follow-up was 5.7 years (2-10).
Results: We analyzed 41 patients (Schatzker I-III), average age 46.7 ± 13.0 years. Traumatic lesion of the lateral meniscus was present in 15 (36.58%) patients. Post-traumatic knee osteoarthritis was present in all (100%) patients after lateral meniscectomy and in 20% of patients it occurred after meniscus repair (p = 0.007). Post-traumatic knee osteoarthritis was present in 12 (29.68%) patients. Infection occurred in five (12.19%) patients, DVT in three (7.3%) patients, and we had one (2.43%) case of non-lethal PE. Final functional outcomes were excellent in 13 (31.7%), good in 21 (51.21%), moderate in five (12.19%), and poor in two (4.87%) patients.
Conclusion: Lateral tibial plateau fractures are severe intra-articular injuries which can leave lasting consequences, regardless of the restoring of the articular surface and stable internal fixation. Local skin condition and associated soft tissue injuries, comminution, degree of dislocation, and depression can significantly affect the development of post-traumatic osteoarthritis and poor outcomes.
Databáze: MEDLINE
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