Our Results Of Surgical Treatment Of Tibial Plateau Fractures

Year 2010, Volume: 4 Issue: 1, 251 - 254, 21.03.2010

Serhan Ünlü

Abstract

We aimed to evaluate the radiological and functional results of surgically treated 32 tibial plateau fractures between June 2006 - October 2008 at our clinic respectively.
32 patients who were applied open reduction and internal fixation with a diagnosis of tibial plateau fractures were included in the study. 9 female, 23 male patients with age range 15-70 (average age: 42.5) was detected. Patients who were evaluated with Schatzker classification radiologically to Type 2 to 5 and functionally with Rasmussen criteria.
The average follow up period was 17 months (5-28 months). 10 patients were evalutated to have Type 2, 9 patients Type 3, 6 patients Type 4 and 7 patients Type 5. At radiologic evaluation of 32 patients; 24 of them was very good, 6 was good, 2 was with fair results. At functional evaluation, there was very good functional results at 25 patients, good in 5 patients, 2 patients were considered to be fair. Early postoperative infection developed at 1 patient as superficial tissue infection, no complications were detected at late folow up.
Surgical evaluation of tibial plateau fracture which usually developes after high-energy trauma is important especially with regard to post operative functional results. A through preoperative physical examination and evaluation of the fracture radiologically with direct graphic evaluation and computed tomography is important fort he postoperative outcome.

Keywords

tibia plateau, locking plate, surgical treatment.

Tibia Plato Kırıklarında Cerrahi Tedavi Sonuçlarımız

Abstract

Kliniğimizde Haziran 2006- Ekim 2008 tarihleri arasında cerrahi olarak tedavi edilen 32 tibia plato kırığının radyolojik ve fonksiyonel sonuçlarını geriye dönük olarak değerlendirmeyi amaçladık.
Tibia plato kırığı tanısıyla açık redüksiyon ve internal tespit uygulanan 32 hasta çalışmaya dahil edildi. Hastaların 9’u kadın, 23’ü erkek; yaş aralığı 15-70 (ortalama yaş: 42,5) olarak tespit edildi. Radyolojik olarak Schatzker Sınıflamasına göre Tip 2 - 5 olarak değerlendirilen hastalar, fonksiyonel olarak Rasmussen kriterleri ile değerlendirildi.
Ortalama takip süreleri 17 ay (5-28 ay) olarak kaydedildi. 10 hasta Tip 2, 9 hasta Tip 3, 6 hasta Tip 4, 7 hasta Tip 5 olarak değerlendirildi. 32 hastanın radyolojik değerlendirilmesi sonrası 24 tanesi çok iyi, 6 tanesi iyi, 2 tanesinde orta sonuç olarak değerlendirildi. Fonksiyonel sonuçlar 25 hastada çok iyi, 5 hastada iyi, 2 hastada orta olarak değerlendirildi. Postoperatif erken dönemde 1 hastada yüzeyel doku enfeksiyonu gelişti, geç dönemde herhangi bir komplikasyon saptanmadı. Genellikle yüksek enerjili travmalar sonrası gelişen tibia plato kırıklarının cerrahi tedavisinin planlaması özellikle fonksiyonel sonuçlar açısından önem arzetmektedir. Preoperatif iyi bir fizik muayene, radyolojik olarak direk grafi ve bilgisayarlı tomografi ile kırık değerlendirilmesi postoperatif sonuçlar üzerinde önemlidir.

Dr. Serhan Ünlü,
Dr. Tuğhan Kalkan,
Dr. Birol Tunç,
Dr. Yenel Gürkan Bilgetekin,
Dr. Mehmet Akif Teber, Dr. Murat Bozkurt

Keywords

tibia plato, kilitli plak, cerrahi tedavi

References

• 1. Gausewitz S, Hohl M. The significance of early motion in the treatment of tibial plateau fractures. Clin Orthop 1986;202:135-138.
• 2. Stannard JP, Wilson TC, Volgas DA, Alonso JE. The less invasive stabilization system in the treatment of complex fractures of the tibial plateau: short-term results. J Orthop Trauma 2004;18:552-558.
• 3. Resnic D, Niwoyama G. Diagnosis of Bone and Joint Disorders. Philadelphia: WB Saunders Co, 1981
• 4. Rasmussen PS. Tibial condyler fractures. Impairment of knee joint stability as an indication for surgical treatment. J Bone Joint Surg (Am) 1973;55:1331-1350.
• 5. Aksoy B, Öztürk K, Olcay E, Kara AN, Alpay A, Basic B. Plato tibia kırıklarının cerrahi tedavisi. Acta Orthop Traumatol Ture 1995;29:133-5.
• 6. Lee AJ, Papadakis SA, Moon C, Zalavras CG. Tibial plateau fractures treated with the less invasive stabilisation system. International Orthopaedics (SICOT) 2007;31:415-418.
• 7. Tscherne H, Lobenhoffer P. Tibial plateau fractures: management and expected results. Clin Orthop 1993;292:87.
• 8. Hohl M. Treatment methods in tibial condylar fractures. South Med J 1975;68:985.
• 9. Bennett WF, Browner B. Tibial plateau fractures: a study of associated soft tissue injury. J Orthop Trauma 1994;8:183.
• 10. Colletti P, Greenberg H, Terk MR. MR findings in patients with acute tibial plateau fractures. Comput Med Imaging Graph 1996;20:389-94.
• 11. Gür B, Akman Ş, Aksoy B, Tezer M, Öztürk İ, Kuzgun Ü. Tibia plato kırıklarının cerrahi tedavisi. Açta Orthop Trau Turc 2003;37:113-119.
• 12. Hohl M, Moore TM. Articular fractures of the proximal tibia. In: Evarts M, editor. Surgery of the musculoskeletal system. 1st ed. New York: Lippincott; 1983. p. 111-34.
• 13. Itokazu M, Matsunaga T. Arthroscopic restoration of depressed tibial plateau fractures using bone and hydroxyapatite grafts. Arthroscopy 1993;9:103.
• 14. Krettek C, Gerich T, Miclau T A minimally invasive medial approach for proximal tibial fractures. Injury 2001;32(S3):4-13.