Skip to main content

Advertisement

SpringerLink
Log in

Angular stable plates in proximal meta-epiphyseal tibial fractures: study of joint restoration and clinical and functional evaluation

  • Original Article
  • Published:
MUSCULOSKELETAL SURGERY Aims and scope Submit manuscript

Abstract

Background

The tibial plateau fractures involve one of the main weight bearing joints of the human body. The goals of surgical treatment are anatomical reduction, articular surface reconstruction and high primary stability. The aim of this study was to evaluate the clinical and functional outcomes after internal plate fixation of this kind of fractures.

Materials and methods

From January 2009 to December 2012, we treated 75 cases of tibial plateau fracture with angular stable plates. We used Rasmussen Score and the Knee Society Score for the clinical and functional evaluation. Twenty-five cases that underwent hardware removal had arthroscopic and CT evaluation of the joint.

Results

No complications occurred. The clinical and functional evaluation, performed by the KSS and Rasmussen Score, highlighted the high percentage of good-to-excellent results (over 90 %). In every case, the range of motion was good with flexion >90°. Arthroscopy showed the presence of chondral damage in 100 % of patients. In all the cases, we found that X-ray images seem better than the CT images.

Conclusions

Angular stable plates allow to obtain a good primary stability, permitting an early joint recovery with an excellent range of motion. Avoiding to perform a knee arthrotomy at the time of fracture reduction could prove to be an advantage in terms of functional recovery. The meniscus on the injured bone should be preserved in order to maintain good function of the joint. X-ray images remain the gold standard in checking the progression of post-traumatic osteoarthritis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Tahririan MA et al (2014) Comparison of functional outcomes of tibial plateau fractures with non locking and locking plate fixations: a non randomized clinical trial. ISRN Orthop. 2014:324573. doi:10.1155/2014/324573

    PubMed  PubMed Central  Google Scholar 

  2. Jöckel JA et al (2013) Minimally invasive and open surgical treatment of proximal tibia fractures using a polyaxial locking plate system: a prospective multi-centre study. Int Orthop 37(4):701–708

    Article  PubMed  PubMed Central  Google Scholar 

  3. Sament R et al (2012) Closed reduction and percutaneous screw fixation for tibial plateau fractures. J Orthop Surg (Hong Kong) 20(1):37–41

    Google Scholar 

  4. Biggi F et al (2010) Tibial plateau fractures: internal fixation with locking plates and the MIPO technique. Injury 41(11):1178–1182

    Article  CAS  PubMed  Google Scholar 

  5. Wang H et al (2013) An improved reduction technique for depression fractures of lateral tibial plateau. Chinese J Reparative and Reconstr Surg 27(1):12–16

    CAS  Google Scholar 

  6. Jansen H et al (2013) Medium term results after complex intra articular fractures of the tibial plateau. J Orthop Sci 18(4):569–577

    Article  PubMed  Google Scholar 

  7. Chan C et al (2012) Comparison of outcomes of operatively treated bicondylar tibial plateau fractures by external fixation and internal fixation. Malays Orthop J 6(1):7–12

    PubMed  PubMed Central  Google Scholar 

  8. Iundusi R et al (2015) Augmentation of tibial plateau fractures with an injectable bone substitute: CERAMENT™. Three year follow-up from a prospective study. BMC Musculoskelet Disord 16(1):115

    Article  PubMed  PubMed Central  Google Scholar 

  9. Qiu WJ et al (2015) A posterior reversed L-shaped approach for the tibial plateau fractures: a prospective study of complications (95 cases). Injury 46(8):1613–1618

    Article  PubMed  Google Scholar 

  10. Jöckel JA et al (2013) Proximal tibia fracture treatment with a new locking device with polyaxial screw placement: technique and early results. Z Orthop Unfall 151(1):85–92

    PubMed  Google Scholar 

  11. Pasa L et al (2007) Treatment of intra-articular proximal tibial evaluation of two- to seven-year follow-up. Acta Chir Orthop Traumatol Cech 74(5):336–341

    CAS  PubMed  Google Scholar 

  12. Hartigan DE et al (2015) Arthroscopic-assisted reduction and percutaneous fixation of tibial plateau fractures. Arthrosc Tech 4(1):e51–e55

    Article  PubMed  PubMed Central  Google Scholar 

  13. Lizaur-Utrilla A et al (2015) Total knee arthroplasty for osteoarthritis secondary to fracture of the tibial plateau. A prospective matched cohort study. J Arthroplasty 30(8):1328–1332

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. IInd Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy

    S. Giannotti, D. Giovannelli, G. Dell’Osso, V. Bottai, G. Bugelli, F. Celli, C. Citarelli & G. Guido

Authors
  1. S. Giannotti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. Giovannelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Dell’Osso
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. V. Bottai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G. Bugelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. F. Celli
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. C. Citarelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. G. Guido
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Giannotti.

Ethics declarations

Conflict of interest

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Giannotti, S., Giovannelli, D., Dell’Osso, G. et al. Angular stable plates in proximal meta-epiphyseal tibial fractures: study of joint restoration and clinical and functional evaluation. Musculoskelet Surg 100, 15–18 (2016). https://doi.org/10.1007/s12306-015-0389-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12306-015-0389-5

Keywords

Search

Navigation