Tratamiento quirúrgico de fractura de meseta tibial Schatzker tipo VI: reporte de un caso y revisión de la literatura / Surgical treatment of Schatzker tibial plateau fracture type VI: report of a case and review of the literature

Introducción: las fracturas de alta energía de la meseta tibial pueden causar problemas relacionados con el manejo, por la severa conminación que conduce a una mala alineación; y complicaciones tardías tales como la artrosis postraumática. El tratamiento puede ser bastante difícil, por su gravedad y las secuelas funcionales. Se presenta el caso de una fractura de meseta tibial Schatzker VI resuelta quirúrgicamente con doble placa. Caso Clínico: se trata de un hombre de 34 años previamente sano que se presentó a la sala de emergencias después de una caída mientras realiza competición de bicicleta de montaña, sufre trauma axial en varo forzado de rodilla izquierda. Las radiografías mostraron una fractura conminuta de meseta tibial que afectaron las dos plataformas, que fue clasificada según Schatzker como tipo VI. Se realizó 2 tiempos quirúrgicos; se colocó primariamente tutores externos hasta que el complejo secundario disminuya y posteriormente se realizó la cirugía definitiva con doble placa, obtuvimos una recuperación satisfactoria. Conclusiones: el manejo de fracturas complejas de meseta tibial requieren un adecuado entendimiento del patrón de fractura, su relación con las partes blandas y tener un protocolo terapéutico oportuno, esperando el tiempo prudente para realizar una estabilización definitiva, que puede durar varias semanas hasta que el complejo secundario mejore(AU)

Introduction: high energy fractures of the tibial plateau can cause problems related to management, due to the severe comminution that leads to poor alignment; and late complications such as post-traumatic osteoarthritis. The treatment can be quite difficult, due to its severity and functional sequelae. We present the case of a Schatzker VI tibial plateau fracture resolved surgically with double plaque. Clinical Case: this is a previously healthy 34-year-old man who presented to the emergency room after a fall while doing mountain bike competition, suffering axial trauma in forced varus of the left knee. The radiographs showed a comminuted tibial plateau fracture that affected the two platforms, which was classified according to Schatzker as type VI. 2 surgical times were performed; Primary tutors were placed primarily until the secondary complex decreased and later definitive surgery with double plaque was performed, we obtained a satisfactory recovery. Conclusions: the management of complex tibial plateau fractures requires an adequate understanding of the fracture pattern, its relationship with the soft tissues and having a timely therapeutic protocol, waiting for the prudent time to perform a definitive stabilization, which may last several weeks until the secondary complex improve(AU)

Comparative Analysis of Two Different Fixation Methods for Treatment of the Intercondylar Eminence Fractures of Tibia / 昆明医科大学学报

Objective To compare the effect of hollow screw and double suture anchors for the treatment of the intercondylar eminence fractures of tibia.Methods The data of 68 patients with intercondylar eminence fractures of tibia from January 2006 to January 2012 were retrospectively reviewed.33 patients of them received treatment of hollow screw,35 patients received double suture anchors.All patients had X-ray films before operation.After follow-up of 3,6,12 and 36 months,they all were examined by X-ray eminence in an appropriate position.Union time was from 6 to 12 weeks and evaluated by Lysholm system.Results After a follow-up for 24 to 43 months and the average period was 36 months.A total of 68 patients turned up.The outcome of treatment was evaluated on the basis of X-ray and clinical findings in hollow screw group and double suture anchors group.Union and average time was 8 weeks.During the follow-up time,clinical evaluation included the range of motion and knee joint stability was examined and no knee joint instability and abnormal activity were found.During the 3 months and 6 months,there were significant differences between hollow screw group and double suture anchors group (P ＞ 0.05).But during the follow-up from 12 to 24 months,there were significant differences between hollow screw group and double suture anchors group (P＞0.05) according to Lysholm system,clinical evaluation including range of motion and knee pain was examined and knee pain and abnormal activity were found in this two groups.Conclusion Clinical characteristics of patients and individual requirement should be considered comprehensively before an individual treatment choice is made for the treatment of the intercondylar eminence fractures of tibia.