[Surgical treatment of tibial plateau fractures].
OBJECTIVE
This study was designed to determine surgical indications in tibial plateau fractures and to evaluate the effect of surgical treatment on the outcome.


METHODS
Forty patients (12 women, 28 men; mean age 39 years; range 18 to 75 years) underwent surgical treatment for 41 tibial plateau fractures. Final evaluations included 37 patients (38 knees). Fractures were classified according to the Schatzker's system, being type 1 (11 fractures), type 2 (11), type 3 (1), type 4 (6), type 5 (5), and type 6 (7). The indications for surgery were defined as the presence of depression, displacement, and instability being greater than 4 mm, 10 mm, and 10 degrees, respectively. The mean follow-up was 35.8 months (range 6 to 107 months).


RESULTS
Clinical results were assessed using the Rasmussen criteria. Successful results accounted for 86.8%. The results were excellent, good, moderate, and poor in 14 knees (36.8%), 19 knees (50%), three knees (7.9%), and 2 knees (5.3%), respectively. Postoperative complications included deep (2 patients) and superficial (2 patients) infections, malunion in two patients, arthrofibrosis in three patients, and myositis ossificans in one patient. Radiologic evaluations were based on the Resnic and Niwayama's system, which showed successful outcome in 73.6%. The results were excellent in 11 knees (28.9%), good in 17 knees (44.7%), moderate in six knees (15.8%), and fair in four knees (10.6%).


CONCLUSIONS
In order to achieve satisfactory results in tibial plateau fractures that meet surgical indications including depression (>4 mm), displacement (>10 mm), and instability (>10 degrees), special attention should be given to obtain a rigid osteosynthesis with early mobilization and to avoid weight-bearing until bone healing is completed.
Gür
Bülent
B
Sişli Etfal Eğitim ve Araştirma Hastanesi, Ortopedi ve Travmatoloji Kliniği, Istanbul.
Akman
Senol
S
Aksoy
Bülent
B
Tezer
Mehmet
M
Oztürk
Irfan
I
Kuzgun
Unal
U
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D015601:Injury Severity Score; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D016059:Range of Motion, Articular; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000070600:Tibial Meniscus Injuries; D016896:Treatment Outcome; D014421:Turkey
Tibia plato kiriklarinin cerrahi tedavisi.