ABSTRACT
Introduction@#Tibial plateau fractures are due to high energy trauma brought about by axial compression forces and associated varus or valgus component. @*Objective@#Patients diagnosed with tibial plateau fractures from January to December 2018 treated with internal vs. external fixation will be described according to their Schatzker classification. The study further aims to compare the functional outcomes between the two groups in terms of surgery done. @*Methods@#A chart review determined the distribution of demographics. The Modified Rasmussen Score (MRS) was used to determine the clinical and radiographic parameters after taking a new knee radiograph and assessment from the rehabilitation department. The MRS determined the functional outcomes of the said patients. Ethical considerations and proper informed consent were upheld after being reviewed by the hospital’s research committee. @*Results@#Out of 48 patients, 35 underwent internal fixation via open reduction using plates and/or screws, while 13 underwent external fixation using hybrid external fixator. The demographic profile showed mostly males between ages 20 to 49 years old. Most cases were due to vehicular accidents affecting the left lower extremity. In terms of Schatzker classification, the most common was type VI. The computed mean MRS of the internal fixation group was 30.43 while the external fixation group was 30.00, generally showing no significant difference. @*Conclusion@#Surgical intervention of tibial plateau fractures aims for anatomic reduction using internal or external fixation. There was no significant difference on the functional outcome of the two groups despite classifying the respondents according to Schatzker type, hence we can conclude that external fixation be chosen as the treatment of choice for tibial plateau fractures when properly indicated.
ABSTRACT
Donor safety is the first priority in living donor liver transplantation [LDLT]. To determine the characteristics and outcome of live liver donors who underwent donor hepatectomy from January, 1997 to May, 2007 at Massachusetts General Hospital. 30 patients underwent LDLT between January, 1997 and May, 2007 at our institution. The type of graft was the right lobe [segments 5-8] in 14, left lobe [segments 2-4] in 4, and left lateral sector [segments 2 and 3] in 12 patients. The mean donor age was 36 [range: 26]57] years. The mean follow-up was 48 [range: 18-120] months. No deaths occurred. Overall, 8 [26.6%] patients experienced a total of 14 post-operative complications. Donor complications based on graft type were as follows: left lateral sector [16.7%], left lobed [25%], and right lobe [35.7%]. The experience was divided into two periods 1997-2001 [n=15] and 2002-2007 [n=15]. Overall complications during 2 periods were 40% and 13.3% respectively [p<0.001]. The incidence of grade III complication also significantly decreased; 66.7% vs 33.3% [p<0.01]. Partial hepatectomy in living donors has a learning curve which appears to be approximately 15 cases. This learning curve is not restricted to the surgeons performing the procedure but involves all aspects of patient care