Title

Minimally invasive plate osteosynthesis for tibial plateau fractures.

Document Type

Article

Department

Surgery

Abstract

Purpose:To evaluate radiological and clinical outcome of minimally invasive plate osteosynthesis (MIPO) for tibial plateau fractures.

Methods:

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.

Results:

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).

Conclusions:

MIPO for tibial plateau fractures achieved good outcome with minimal soft-tissue complications. Older age was the predictor of unacceptable outcome.

Publication

Journal of Orthopaedic Surgery (Hong Kong)