Minimally invasive plate osteosynthesis for tibial plateau fractures.
Purpose:To evaluate radiological and clinical outcome of minimally invasive plate osteosynthesis (MIPO) for tibial plateau fractures.
35 men and 6 women aged 19 to 75 (mean, 40, standard deviation [SD], 14) years underwent MIPO for displaced tibial plateau fractures. According to the Schatzker system, the tibial plateau fractures were classified as types I (n=3), II (n=9), III (n=11), IV (n=6), V (n=7), and VI (n=5). Six Patients had open fractures, 2 of them underwent debridement before MIPO. 10 Patients needed additional bone grafting. Radiological (at immediate postoperation) and clinical (at the 12-month follow-up) assessments based on the Rasmussen anatomic and functional scoring system were recorded using a proforma. Patients with acceptable and unacceptable outcomes were compared in terms of age.
The mean Rasmussen anatomic score was 15.1 (SD, 2.2, range, 10-18), the mean Rasmussen functional score was 25.3 (SD, 3.2, range, 14-29), and the mean range of knee motion was 118 (SD, 10, range, 90-140) degrees. Anatomic outcome was excellent in 10, good in 28, and unacceptable in 3 Patients (one each had Schatzker type-I, -II, and -III fractures). 27 (71%) of the 38 Patients with acceptable anatomic outcome were aged 45 years or younger, whereas 2 (67%) of the 3 Patients with unacceptable anatomic outcome were aged 60 years or older (p=0.001). Functional outcome was excellent in 18, good in 19, and unacceptable in 4 Patients (2 had Schatzker type-III and another 2 had Schatzker type-I or -II fractures). 37 of the Patients had a range of knee motion of 120 degrees or more, 27 (73%) of them were aged 45 years or younger, whereas 3 (75%) of the 4 Patients with unacceptable functional outcome were aged 60 years or older (p=0.001).
MIPO for tibial plateau fractures achieved good outcome with minimal soft-tissue complications. Older age was the predictor of unacceptable outcome.
Journal of Orthopaedic Surgery (Hong Kong)
(2012). Minimally invasive plate osteosynthesis for tibial plateau fractures.. Journal of Orthopaedic Surgery (Hong Kong), 20(1), 42-7.
Available at: http://ecommons.aku.edu/pakistan_fhs_mc_surg_surg/57