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Outcome of Schatzker Type VI Tibial Plateau Fractures Treated with Dual Plating
Keywords:
bia plateau fracture, dual plating, Oxford knee scoring system.Abstract
ABSTRACT
Objective: To determine the radiological and functional outcome of dual plating of tibial plateau Schatzkar type VI fracture.
Methods: This descriptive study was conducted in Orthopaedic B unit Lady Reading Hospital Peshawar from February 2015 to August 2017. All patients with type VI tibial plateau fractures fulfilling the inclusion criteria were enrolled. All were treated with dual platting with double incisions. Minimum follow up period was one year. Outcome was assessed radiologically by Modified Rasmussen Assessment Criteria and functionally by Oxford Knee Scoring system.
Results: A total of 42 patients with mean age 36.6 years(range 18-52 years) ±SD 7.7 were treated with dual plating. Male patients were 33(78.5%) while female patients were 9(21.4%). The radiological evaluation at one-year follow up produced excellent results in 33(78.5%) patients, good in 7(16.6%) and fair in 2(4.7%) patients. Functional outcome was excellent in 34(80.9%) patients, good in 5(11.9%), fair in 2(4.7%) and poor in 1(2.3%). 5(11.9%) patients developed superficial wound infection while 2(4.7%) patients suffered from deep wound infection. No delayed union, non-union or deformity was reported.
Conclusion: Schatzker type VI fractures treated with open reduction and dual plating produce excellent and good radiological and functional outcome in majority of patients. We therefore recommend dual plating with two incisions as treatment of choice for the treatment of such fractures.
References
2. Albuquerque RP, Hara R, Prado J, Schiavo L, Giordano V, do Amaral NP. Epidemiological study on tibial plateau fractures at a level I trauma center. Acta Ortop Bras. 2013 Mar-Apr;21(2):109-115.
3. SCHATZKER, JOSEPH M.D., MCBROOM, ROBERT M.D.; BRUCE, DAVID B.A. The tibial plateau fracture: The Toronto experience. 1968-75. Clin Orthop 1979 Jan-Feb;138: 94-104.
4. Barei DP, Nork SE, Mills WJ, Coles CP, Henley MB, Benirschke SK. Functional outcomes of severe bicondylar tibial plateau fractures treated with dual incisions and medial and lateral plates. J Bone Joint Surg Am 2006 Aug;88:1713-1721.
5. Pun TB, Krishnamoorthy VP, Poonnoose PM, Oommen AT, Korula RJ. Outcome of Schatzker type V and VI tibial plateau fractures. Indian J Orthop 2014 Jan-Feb;48(1): 35-41.
6. Ranatunga IR, Thirumal M. Treatment of type VI fractures with the Ilizarov technique using ring external fixators across knee: A retrospective review. Malaysian Orthopaedic Journal 2010; (4) 2:34-39.
7. Yu Z, Zheng L, Zhang Y, Li J, Ma B. Functional and radiological evaluations of high energy tibial plateau fractures treated with double-buttress plate fixation. Eur J Med Res. 2009 May;14(5):200-205.
8. Berkson EM, Virkus WW. High-energy tibial plateau fractures. J Am Acad Orthop Surg 2006 Jan;14:20-31.
9. Tejwani NC, Hak DJ, Finkemeier CG, Wolinsky PR. High-energy proximal tibial fractures: Treatment options and decision making. Instr Course Lect 2006;55:367-379.
10. Jiang R, Luo CF, Wang MC, Yang TY, Zeng BF. A comparative study of Less Invasive Stabilization System (LISS) fixation and two-incision double plating for the treatment of bicondylar tibial plateau fractures. Knee 2008 Mar;15:139-143.
11. Lasanianos NG, Garnavos C, Magnisalis E, Kourkoulis S, Babis GC. A comparative biomechanical study for complex tibial plateau fractures: Nailing and compression bolts versus modern and traditional plating. Injury 2013 Oct;44:1333-9.
12. Ali AM, Yang L, Hashmi M, Saleh M. Bicondylar tibial plateau fractures managed with the Sheffield Hybrid Fixator: Biomechanical study and operative technique. Injury 2001 Dec;32(Suppl 4):86-91.
13. Higgins TF, Klatt J, Bachus KN. Biomechanical analysis of bicondylar tibial plateau fixation: How does lateral locking plate fixation compare to dual plate fixation? J Orthop Trauma 2007 May;21:301-306.
14. Prasad GT, Kumar TS, Kumar RK, Murthy GK, Sundaram N. Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates. Indian J Orthop 2013 Mar-Apr;47(2):188-94.
15. Rohra N, Suri HS, Gangrade K. Functional and radiological outcome of Schatzker type V and VI tibial plateau fracture treatment with dual plates with minimum 3 years follow-up: A prospective study. J Clin Diagn Res 2016 May;10(5):5-10.
16. Cho KY, Oh HS, Yoo JH,Kim DH, Cho YJ,Kim K. Treatment of Schatzker Type V and VI tibial plateau fractures using a midline longitudinal incision and dual plating. Knee Surg Relat Res 3013 Jun;25(2):77-83.
17. Rasmussen PS. Tibial condylar fractures. Impairment of knee joint stability as an indication for surgical treatment. J Bone Joint Surg Am 1973 Oct;55:1331-1350.
18. Williams DP, Blakey CM, Hadfield SG, Murray DW, Price AJ, Field RE. Long-term trends in the Oxford knee score following total knee replacement. J Bone Joint Surg 2013 Jan;95(1): 45-51.
19. Khatri K, Lakhotia D, Sharma V,Kumar GN, Sharma G, Farooque K. Functional evaluation in high energy(shatzker type V and type VI) tibial plateau fractures treated by open reduction and internal fixation. International Scholarly Research Notices 2014 Oct:538-45.
20. Stannard JP, Lopez R, D. Volgas D. Soft tissue injury of the knee after tibial plateau fractures. The Journal of Knee Surgery 2010 Dec:23(4);187-192.
