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La fissazione esterna nelle fratture instabili del piatto tibiale

External fixation in unstable tibial plateau fractures

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Riassunto

Le fratture instabili del piatto tibiale sono fratture ad alta energia che si presentano con la frequente associazione di danni spesso gravi ai tessuti molli. La sintesi interna in questi casi richiede ampie esposizioni chirurgiche e l’utilizzo di due placche con rischio di gravi complicazioni. Per ridurre l’incidenza di tali complicanze preferiamo il ricorso alla fissazione esterna associata alla riduzione cruenta con sintesi interna a minima. Dal 1992 al 2010 abbiamo trattato 86 pazienti affetti da fratture dei tipi V e VI della classificazione di Schatzker. I risultati funzionali sono stati valutati come eccellenti in 32 pazienti, buoni in 48 pazienti, accettabili in 5 pazienti e cattivi in un paziente. In conclusione, il metodo di fissazione esterna circolare combinato con la fissazione interna a minima, nelle fratture instabili del piatto tibiale, ci ha consentito di ottenere buoni o eccellenti risultati nella maggioranza dei casi.

Abstract

Unstable tibial plateau fractures are high-energy fractures frequently associated to severe soft tissues damage. Open reduction and internal fixation require large surgical approaches and the double plating technique, with the risk of severe complications. In order to decrease the incidence of these complications we preferred a combined technique of external fixation and open reduction with minimal internal fixation. From 1992 to 2010 we treated 86 patients with type V and VI fractures (according to Schatzker’s classification). Results were evaluated as excellent in 32 cases, good in 48, fair in 5 and poor in 1 patient. In conclusion, the method of open reduction and minimal internal fixation combined with external fixation allowed us to achieve good and excellent results in the majority of cases.

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Authors and Affiliations

  1. Dipartimento di Ortopedia, Ospedale “A. Manzoni”, Via dell’Eremo 9/11, 23900, Lecco, Italy

    M. A. Catagni, F. Guerreschi & L. Lovisetti

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  1. M. A. Catagni
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  2. F. Guerreschi
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  3. L. Lovisetti
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Correspondence to M. A. Catagni.

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Catagni, M.A., Guerreschi, F. & Lovisetti, L. La fissazione esterna nelle fratture instabili del piatto tibiale. Aggiornamenti 18, 93–98 (2012). https://doi.org/10.1007/s10351-012-0015-z

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  • DOI: https://doi.org/10.1007/s10351-012-0015-z

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