de la Garza-Alatorre F, de la Garza S

Language: Spanish
References: 10
Page: 267-271
PDF size: 434.91 Kb.

ABSTRACT

A series of 13 high-energy, bi-condilar fractures of the tibial plateau in 11 individuals (8 male and 3 female) is reported. There were 7 class V and 6 class VI fractures according to the Schatzker classification. Age was in average 38.6 years. Treatment was in 9 patients by closed percutaneous screws, while in 2 who had open fractures, an immediate surgical debridement was performed in one Gustilo class I open fracture and percutaneous screws in a second time, and in the remaining class III-A open fracture, a debridement and screwing was also performed just in one time. Long-leg casting was always applied. Anatomic reduction was obtained in all patients. Bone union was achieved in 8 weeks in average. A satisfactory range of motion of the knee was recovered by assistance of a rehabilitation program after an average of 3 months. After an average follow-up of 14 months, good results were obtained in 82% of the cases. There were 3 complications: one deep articular infection of the knee, which was treated by operation and antibiotics; one second case who was a psychiatric woman developed osteitis and after diverse procedures her final outcome was knee ankilosis; the last one was a woman who failed to achieve a functional range of movement because of lack of cooperation with the rehabilitation program. It is concluded that the present procedure can be a useful resource for treatment of bicondilar fractures.

REFERENCES

1. Brown GA, Sprague BL. Cast brace treatment of plateau and bicondylar fractures of the proximal tibia. Clinic Orthop 1976; 119: 184-193.

2. Browner, Jupiter, Levine, Traftan. Skeletal trauma. 1a edición, Pennsylvania, Philadelphia, W.B. Saunders Company 1992; 2: 1745-1769.

3. Canale ST. Campbell’s Operative Orthopaedics, 9a edición, St. Louis Missouri, Mosby 1998; 3: 2094-2111.

4. Duwelius PJ, Rangitsch MR, Colville MR, Woll ST. Treatment of tibial plateau fractures by limited internal fixation. Clinic Orthop 1997; 339: 47-57.

5. Gausewitz S, Hohl M. The significance of early motion in the treatment of tibial plateau fractures. Clinic Orthop 1986; 202: 135-138.

6. Honkonen SE. Indications for surgical treatment of tibial condyle fractures. Clinic Orthop 1994; 302: 199-205.

7. Marsh JL, Smith ST, Do TT. External fixation and limited internal fixation for complex fractures of the tibial plateau. J Bone Joint Surg 1995; 77(A): 661-672.

8. Rockwood CA, Green DP, Bucholz RW, Heckman JD. Rockwood and Green’s fractures in adults, 4a edition, East Washington Square, Philadelphia, Lippincott-Raven Publishers 1996; 2: 1919-1954.

9. Stamer DT, Schenk R, Staggers B, Aurori K, Aurori B, Behrens FF. Bicondylar tibial plateau fractures treated with hybrid ring external fixator: a preliminary study. J Trauma 1994; 8(6): 455-461.

10. Touliatos AS, Xenakis T, Soucacos P, Soucacos PN. Surgical management of tibial plateau fractures. Acta Orthop Scand 1997; 68: 92-96.