Tibial plateau fractures management

Abstract

The aim: Presenting the methods of evaluation and management of patients with tibial plateau fractures treated in Orthopedics and Traumatology Clinic "V. Bețișor" during 2014-2015 years. Materials and methods: There were analyzed 110 clinical cases with tibial plateau fractures: men – 46(42%) and women – 64(58 %), with mean age 52,4 years. Trauma circumstances: habitual trauma – 69 cases, traffic accident – 18, precipitation – 12, sport – 7, aggression – 4. Fractures were classified as Schatzker: type I – 14 cases, II – 28, III – 17, IV – 10, V – 28, VI – 13, including 107 close, 3 open (Gustillo-Andersen type I). All patients were examined by X-ray, 78 by CT. Management tactics applied: 68 patients- surgical treatment, 42 cases – orthopaedic. Surgical treatment consisted of close reduction – 8 cases (6 - percutaneus canulated screws, 2- Ilizarov apparatus), open reduction – 60 cases: 49- plate (15 with submeniscal approach), 11- 2 plates. It was performed autoostheoplaty in 12 cases (3-type II, 4-III, 2-V, 3-VI). Results: Until the present 50% of patients were examined clinicaly, radiologicaly and evaluated according to Lysholm Knee Scoring Scale to a term of 3,6,12,24 months. Bone consolidation was achieved in a period of between 10 to 20 weeks. To 8 patients during the postoperative period appeared complications, which were depending on the complexity of fractures and accuracy of surgical treatment. Remote results were depending on the stability of osteosynthesis, precocity, rightness of functional reeducation and patient compliance. Conclusions: Individual approach of tibial plateau fractures management, the right choice of implants and minimally invasive surgical techniques is an optimal tactics to obtain favorable functional results and avoid possible complications.