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Does a staged treatment of high energy tibial plateau fractures affect functional results and bony union?A case series

查看全文 作　　者：Nilesh [1]Barwar;Abhay [2]Elhence;Sumit [2]Banerjee;Nitesh [2]gahlot 高影响力作者 机构地区：[1]Department of Trauma&Emergency Orthopedics,All India Institute of Medical Sciences,Jodhpur 342005,India;[2]Department of Orthopedics,All India Institute of Medical Sciences,Jodhpur 342005,India高影响力机构 出　　处：《Chinese Journal of Traumatology》索引2020年第23卷第4期,共5页高影响力期刊 摘　　要：Purpose:Tibial plateau fracture(TPF)is a devastating injury as it shatters lower articular surface of the largest joint.Apart from bony injury,TPF can lead to great soft tissue envelope compromise which affects the treatment plan and outcome.In the present study,clinical results were assessed in cases of high energy TPFs treated in staged manner.Methods:Twenty-three(20 males and 3 females)patients of high energy communited TPFs(Schatzker typeⅤandⅥ)were consecutively treated.1 All the patient had compromise of overlying skin conditions.They were all successively scheduled for staged treatment plan which comprised of application of bridging knee external fixator on the first day of admission and definitive internal fixation after skin and soft tissue overlying the fracture were healed.Schatzker typeⅠ,Ⅱ,ⅢandⅣwere excluded from the study.Primary survey was done and patient who had head injury,chest and abdominal injury,pelvic injury and contralateral limb injury and open fractures were excluded from the study.The patients were also evaluated in terms of wound complications,axial and rotary alignment of limb,fixation failure,articular congruity and range of motion of the knees and post injury employment.Statistical analysis was done using SPSS software.Results:Maximum follow-up period was 13 months.All the fractures were united at final follow-up.Clinical evaluation was done with the Tegner Lysholm knee scoring scale.2 Excellent results were found in 78%cases and good and fair results in 22%cases.There was significant correlation between range of motion and the Tegner Lysholm knee score(p<0.001,Pearson correlation coefficient=0.741).The correlation between the score and the radiographical union duration was significant(p=0.006,Pearson correlation coefficient=-0.554).Conclusion:A staged treatment plan allows healing of soft tissue envelope,with avoidance of dreadful complications such as compartment syndrome and chronic infection.In addition,a staged treatment strategy does not hamper the fracture reduction,bony union and the functional results. 关 键 词：High energy fracture Tibial plateau fractures Staged treatment
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