Tibial plateau fractures: functional outcome and incidence of osteoarthritis in 125 cases
Autor: | Nikolaos Manidakis, Dirk Stengel, Anis Dosani, Rozalia Dimitriou, Peter V. Giannoudis, Stuart E. Matthews |
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Rok vydání: | 2009 |
Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_specialty Adolescent medicine.medical_treatment Bone Screws Knee Injuries Osteoarthritis Menisci Tibial Fracture Fixation Internal Young Adult Postoperative Complications Traction Fracture fixation Humans Minimally Invasive Surgical Procedures Medicine Internal fixation Orthopedics and Sports Medicine Aged Retrospective Studies Aged 80 and over Original Paper biology business.industry Recovery of Function Middle Aged Osteoarthritis Knee biology.organism_classification medicine.disease Arthroplasty United Kingdom Tibial Meniscus Injuries Surgery Radiography Tibial Fractures Casts Surgical Valgus Orthopedic surgery Female business Range of motion |
Zdroj: | International Orthopaedics. 34:565-570 |
ISSN: | 1432-5195 0341-2695 |
Popis: | Tibial plateau fractures occur due to a combination of axial loading and varus/valgus applied forces leading to articular depression, malalignment and an increased risk of posttraumatic osteoarthritis (OA) [14, 19]. When treating intra-articular fractures, the goal is to obtain a stable joint permitting early range of motion for cartilage nourishment and preservation [19]. Various treatment modalities have been used over the years, with mixed results. These include traction [3] or closed treatment with cast bracing [9, 16]. Surgical procedures including circular frames [1, 2, 18], percutaneous screw fixation [17], open reduction/internal fixation (ORIF) [1, 5, 6, 10, 28] and arthroplasty have also been advocated. More recent techniques such as the use of fixed angle devices [12, 20], arthroscopically-assisted reduction [8], calcium based cement augmentation [26, 29] and the use of novel grafting methods to address articular depression [4], constantly gain popularity amongst orthopaedic surgeons. Protection from weight bearing and length of immobilisation receive varied emphasis among authors [2, 11, 27]. Despite anatomical joint reconstruction, development of osteoarthritis may still occur secondary to the initial articular cartilage and meniscal injury [14, 21]. In young patients this could be detrimental as it can lead to total knee replacement (TKR) at an early age. In addition, these fractures may have significant socio-economic influence, mainly due to time taken off work. In order to assess the effect of these injuries on functional outcome and development of OA, we retrospectively reviewed a series of tibial plateau fractures treated in our institution. |
Databáze: | OpenAIRE |
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