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Angular-stable locking plate fxation of tibial plateau fractures-clinical and radiological midterm results in 101 patients

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Abstract

Background

Articular reconstruction and stable fxation of tibial plateau fractures and its various subtypes continue to represent a surgical challenge. Only few trials have studied results following angular stable plate fxation. The present study aimed to investigate the clinical, radiological, functional and quality of life results following tibial plateau fractures using angular stable plate fxation.

Materials and Methods

101 patients were retrospectively studied using functional (ROM; KSS; VAS), radiographic (osteoarthritis score, loss of reduction) and quality of life (WOMAC; Lysholm) scores. There were 46 males and 55 females. The average of patients was 51 years (range 22-77 years). Study groups were assigned according to the AO fracture classifcation.

Results

Mean followup was 57 ± 30 months. Fracture type distribution revealed a signifcantly (P < 0.001) increased number of type B- (62.4%) compared to C-fractures. Functional assessment showed a signifcantly better total KSS (84.1 ± 15.6 vs. 74.7 ± 18.0; P = 0.01) as well as ROM (active: 124°±17° vs. 116°±15°, P = 0.014; passive: 126°±18° vs. 118 ± 14°, P = 0.017) in the B-fracture group. VAS was found to be markedly higher (P = 0.0039) following type C-fractures. Rating osteoarthritis secondary to a tibial plateau fracture as a function of injury severity (r = 0.485; P < 0.001) and relating the loss of reduction to the grade of evolving osteoarthritis (r = 0.643; P < 0.001) a positive correlation was found. Quality of life showed signifcantly improved results for Lysholm score (P = 0.004) following B-fractures with low overall values for the WOMAC score.

Conclusion

Presented data provide suffcient evidence that anatomic restoration of tibial plateau fractures with angular stable plate fxation result in decreased loss of reduction and declined incidence of posttraumatic osteoarthritis, thereby providing acceptable mid to long term outcome.

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Authors and Affiliations

  1. Center for Musculoskeletal Surgery, Charité University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Sven Märdian, Felix Landmann, Florian Wichlas, Norbert P. Haas, Klaus-Dieter Schaser & Philipp Schwabe

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  1. Sven Märdian
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Märdian, S., Landmann, F., Wichlas, F. et al. Angular-stable locking plate fxation of tibial plateau fractures-clinical and radiological midterm results in 101 patients. IJOO 49, 620–629 (2015). https://doi.org/10.4103/0019-5413.168755

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