Radiological and therapeutic study of posterior bicondylar tibial plateau fractures / 中华创伤杂志

ABSTRACT

ObjectiveTo investigate the radiological characteristics,morphological characteristics of fracture fragments and treatments of posterior bicondylar tibial plateau fractures.MethodsA total of 47 patients with posterior bicondylar tibial plateau fractures treated between March 2005 and February 2009 were enrolled in the study.Characteristics of fractures and morphologies of fracture fragments were measured precisely with CT-chip Starpacs system.A retrospective study was carried out on the therapeutic results of the 47 patients undergone lateral condylar plate and medial condylar lag screw fixation via anterolateral combined with anteromedial tibial plateau approaches.Results Posteromedial condylar fracture was split one with small displacement,but the fracture was unstable.In the meantime,the fracture fragments were inverted three prism in shape and remained quite intact.Posterolateral condylar fracture was compression one and was often associated with soft tissue injury of knee joints.According to the Rasmussen radiology score,the results were excellent in 24 patients,good in 18,fair in three and poor in two.According to the Rasmussen function score,the results were excellent in 13 patients,good in 27,fair in two and poor in five.ConclusionsThe morphous of posteromedial condylar fracture is similar with that of Hohl type E fracture.The posterolateral condylar fracture is compression one.Anterolateral combined with anteromedial approaches for posterior tibial plateau fractures allow stage Ⅰbone fusion with internal fixation,simultaneously repair recombined injuries and achieve excellent radiological and clinical results.