Acta Chir Orthop Traumatol Cech. 2009; 76(5):363-373 | DOI: 10.55095/achot2009/071
Current Concepts in Tibial Plateau FracturesCurrent concepts review
- 1 Princess Alexandra Hospital, Brisbane, Australia
- 2 Orthopaedic and Trauma Queensland, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
Tibial plateau fractures can range from a simple lateral split pattern to very complex bicondylar injuries that can be a source of great disability. these fractures can provide a challenge for both junior as well as for senior surgeons alike. careful evaluation of the mechanism of injury and fracture pattern plays a crucial part in the operative planning. Assessment of the soft tissues shoul be performed carefully and adequate imaging is mandatory to allow a more detailed evaluation of the fracture architecture and pre-operativeplanning. Timely accurate reduction and fixation is the goal. Over the last decade the surgical approach chosen has been largely determined by the fracture pattern. Internal plate osteosynthesis through antero-lateral and postero-medial incisions is the most commonly utilised technique for complex bi-condylar fractures. An early range of motion with special attention to full knee extension is essential for a successful functional outcome. Application of the principles mentioned is a pre-requisite to achieve the best result. New fixation techniques, such as locking plates, have not changed those principles but helped to apply them more reliably.
Published: October 1, 2009 Show citation
References
- ALI, A. M., YANG, L., HASHMI, M., SALEH, M.: Bicondylar tibial plateau fractures managed with the Sheffield Hybrid Fixator. Biomechanical study and operative technique. Injury, 32, Suppl. 4:SD86-91.
- AO website: http://www.aofoundation.org
- BAREI, D. P., NORK, S. E., MILLS, W. J., et al.: Complications associated with internal fixation of high-energy bicondylar tibial plateau fractures utilizing a two-incision technique. J. Orthop. Trauma, 18:649-57, 2004.
Go to original source...
Go to PubMed...
- BAREI, D. P., NORK, S, E., MILLS, W. J. et al. Functional outcomes of severe bicondylar tibial plateau fractures treated with dual incisions and medial and lateral plates. J. Bone Jt Surg., 88-A:1713-21, 2006.
Go to original source...
Go to PubMed...
- BENNETT, W. F., BROWNER, B.: Tibial plateau fractures: a study of associated soft tissue injuries. J. Orthop. Trauma, 8:183-8, 1994.
Go to original source...
Go to PubMed...
- COLE, P. A., ZLOWODZKI, M., KREGOR, P. J.: Less Invasive Stabilization System (LISS) for fractures of the proximal tibia: indications, surgical technique and preliminary results of the UMC Clinical Trial. Injury, 34 Suppl 1:A16-29, 2003.
Go to original source...
Go to PubMed...
- EBRAHEIM, N. A., SABRY, F. F., HAMAN, S. P.: Open reduction and internal Fixation of 117 tibial plateau fractures. Orthopaedics, 27:1281-1288, 2004.
Go to original source...
Go to PubMed...
- EGOL, K. A., TEJWANI, N. C., CAPLA, E. L. et al.: Staged management of high-energy proximal tibia fractures (OTA types 41): the results of a prospective, standardized protocol. J. Orthop. Trauma, 19:448-55, 2005.
Go to original source...
Go to PubMed...
- GUSTILO, R. B., ANDERSON, J. T.: Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyss. J. Bone Jt Surg., 58-A:453-8, 1976.
Go to original source...
- GUSTILO, R. B., MENDOZA, R. M., WILLIAMS, D. N.: Problems in the management of type III (severe) open fractures: a new classification of type III open fractures. J. Trauma, 24:742-6, 1984.
Go to original source...
Go to PubMed...
- KENNEDY, J. C., BAILEY, W. H.: Experimental tibial plateau fractures. J. Bone Jt Surg., 50:1522-34, 1968.
Go to original source...
- LOBENHOFFER, P., GALLA, M.: The direct, dorsal approach to the treatment of unstable tibial postero-medial fracture-dislocations. Unfallchirurg, 106:241-7, 2003.
Go to original source...
Go to PubMed...
- LOBENHOFFER, P., GERICH, T., BERTRAM, T.: Particular postero-medial and postero-lateral approaches for the treatment of tibial head fractures. Unfallchirurg, 100:957-67, 1997.
Go to original source...
Go to PubMed...
- MOORE, T. M.: Fracture-dislocation of the knee. Clin. Orthop., 156:128-40, 1981.
Go to original source...
- MOORE, T. M., PATZAKIS, M. J., HARVEY, J. P.: Tibial plateau fractures: definition, demographics, treatment rationale, and long-term results of closed traction management operative reduction. J. Orthop. Trauma, 1:97-119, 1987.
Go to original source...
Go to PubMed...
- MÜLLER, M. E., ALLGOWER, M., SCHNEIDER, R., WILLENEGGER, H.: Manual of Internal Fixation, 3rd edn. Springer, Berlin Heidelberg, New York, Springer 1999, 142-143.
- PERREN, S. M.: Fracture healing. the evolution of our understanding. Acta Chir. orthop. Traum. èech., 75:241-246, 2008.
Go to original source...
- ROCKWOOD, C. A., GREEN, D. A., BUCHOLZ, R. W.: Fractures. Philadelphia, Lippincott 1991.
- SCHATZKER, J., McBROOM, R., BRUCE, D.: The tibial plateau fracture. The Toronto experience 1968-1975. Clin. Orthop., 138:94-104, 1979.
- SHEPHERD, L., ABDOLLAHI, K., LEE, J., VANGSNESS, C. T., Jr.: The prevalence of soft tissue injuries in nonoperative tibial plateau fractures as determined by magnetic resonance imaging. J. Orthop. Trauma, 16:628-31, 1999.
Go to original source...
Go to PubMed...
- ZIRAN, B. H., HOOKS, B., PESANTEZ, R.: Complex fractures of the tibial plateau. J. Knee Surg., 20:67-77, 2007.
Go to original source...
Go to PubMed...