ABSTRACT
Objective To explore the clinical curative effects of non-weight-bearing area osteotomy of anterior lateral tibial condyle in treating posterior-lateral condyle fracture of tibial plateau.Methods A retrospective analysis was carried out on 24 cases of posterior-lateral condyle fracture of tibial plateau treated by osteotomy of anterior lateral tibial condyle in this hospital from December 2012 to December 2015,including 15 males and 9 females,aged 26-59 years old with an average age of 42.2 years old.Fracture Schatker classification:type Ⅱ in 16 cases,type Ⅴ in 3 cases and type Ⅵ in 5 cases.All 24 cases adopted surgical treatment via the approach of anterior lateral tibial condyle.During operation,the non-bearing area of lateral tibial condyle was cut to expose and reset the posterior-lateral fractured condyle and fix it with lateral raft steel plate.At the time of last follow-up,the recovery of the knee joint function was evaluated according to the knee scoring system of Hospital for Special Surgery (HSS) in USA.Results Twenty-four patients were postoperatively followed up for 12-24 months,with an average of 13.1 months.The Rasmussen score for the postoperative immediate fracture reduction quality averaged (17.3 ± 0.8)points;there were 19 cases of excellent results and 5 cases of good results,with the excellent and good rate of 100 ％.Twenty-four cases had no incision infection,no internal fixation loosening or breakage.The X ray film showed that the fracture got healing,and the average healing time was (13.1 ± 1.1) weeks(12-15 weeks).No surgery related complications including blood vessel and nerve damage occurred;2 cases appeared small area of superficial necrosis at the edge of the posterior incision,which was healed after dressing.At the last follow-up,the HSS knee score was(93.0±6.4) points,excellent in 19 cases,good in 4 cases,and fair in 1 case,with the excellent and good rate of 95.8％.Conclusion For the patients with posterior-lateral condyle fracture of tibial platform,non-weight-bearing area osteotomy approach of lateral tibial condyle allows enough space to directly expose the fracture area and carry out operation;combined with lateral raft locking steel plate fixation is more reliableto fixthe fractured bone,with convenient operation positioning,good postoperative functional recovery,fewer complications,and satisfied curative effects.
ABSTRACT
Objective To compare the effects of two surgical procedures via comparison on tibial fractures with/without proximal fibula fractures ,and to explore the reference importance of proximal fibula fractures in surgery for complex tibial plateau fracturesinvolvingposterior and lateral spine .Methods Totally 69 cases of patients with complex tibial plateau fracturesinvolving‐posterior and lateral spine (Schatzker Ⅴ and Ⅵ) were selected ,who accepted treatment between January 2008 and October 2012 . The patients were screed according to the quality of fracture reduction immediately after operation .39 cases were screened whose scores were excellent and the general condition was similar .The patients were divided into group A1 ,A2 and B1 and B2 according to the whether there was proximal fibula fractures and whether accepted posterior lateral support steel plate:group A1 (n=10):without proximal fibula fractures but with posterior lateral support steel plate;group A2 (n=11):without proximal fibula fractures and without posterior lateral support steel plate;group B1 (n=9):with proximal fibula fractures and with posterior lateral support steel plate;group B2 (n=9):with proximal fibula fractures but without posterior lateral support steel plate .According to the knee scoring system of American Hospital for Special Surgery (HSS) ,a total of 39 cases of patients were followed up for 12-14 months (average 12 .8 months) to evaluate the recovery condition of knee function .And correlations between the scores of the 4 groups were compared .Results There were statistically significant differences between group B1 and group B2 on HSS scores (P0 .05) .Conclusion For patients with complex tibial plateau fracturesin‐volvingposterior and lateral spine and with proximal fibula fractures ,posterior lateral support steel plate can achieve more satisfac‐tory rehabilitation function .