Abstract
Schatzcker type 3 tibial plateau fractures are common intra-articular injuries. These fractures can be associated with significant depression of articular surface, usually requiring open reduction, elevation of articular surface and rigid internal fixation. The resultant metaphyseal defect is filled with either cancellous autografts (Lachiewicz in Clin Orthop Relat Res 259:210–215, 1990) allografts or calcium phosphates to maintain the reduction. Percutaneous fixation (Koval in J Orthop Trauma 6:340–346, 1992) and ring fixators have been used to stabilize these fractures. Autogenous bone-graft harvesting is associated with significant morbidity with reported major complication rate of 8.6% and minor complication rate of 20.6% and there is a limited availability for larger defects. Allografts and bone substitutes are associated with their own problems (Segur in Arch Orthop Trauma Surg 117(6,7):357–359, 1998). The purpose of this study was to review the outcome of split depressed tibial plateau fractures treated by open reduction and internal fixation using subchondral raft plate fixation without the use of bone graft.
Résumé
Les fractures du plateau tibial de type Schatzcker 3 sont habituellement des fractures intra-articulaires. Elles peuvent s’accompagner de déformations en écuelle significatives, que l’on traite par réduction à ciel ouvert, relèvement de la surface articulaire et fixation rigide. Le défect de la métaphyse est comblé soit par de l’os spongieux autologue, soit par allogreffes, soit par substituts, afin de maintenir la réduction. Des fixations percutanées ou des fixateurs externes ont été préconisés dans cette indication. Le prélèvement de greffons autogènes est grevé de morbidité significative, avec un taux de complications graves de 8.6 et de 20.6% pour des complications mineures ; et la fiabilité est faible pour les enfoncements importants du plateau tibial. Le but de ce travail a été d’évaluer les résultats des fractures séparations du plateau tibial traitées par réduction à ciel ouvert et fixation interne en utilisant des vis sous-chondrales sans ajout de greffe osseuse.
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Langhi, S., Gul, R., Owens, D. et al. Outcome of raft plate fixation of split depressed tibial plateau fracture without using a bone graft. Eur J Orthop Surg Traumatol 17, 77–79 (2007). https://doi.org/10.1007/s00590-006-0109-9
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DOI: https://doi.org/10.1007/s00590-006-0109-9