Functional outcome of tibial plateau fractures treated with the fine-wire fixator.
OBJECTIVE
To review the functional outcome of patients with complex tibial plateau fractures treated with fine-wire fixation.


METHODS
Retrospective review with follow-up of patients in outpatient clinic.


METHODS
Tertiary trauma center.


METHODS
All patients who had fine-wire fixation for tibial plateau fractures between 1996 and January 2001 were reviewed.


METHODS
Fine-wire fixation with/without limited internal fixation for complex tibial plateau fractures.


METHODS
Knee range of motion, adequacy of articular surface reduction, mechanical axis, Knee Society Clinical Rating Scale and Short-Form 36 Health Questionnaire.


RESULTS
Eighteen of twenty-one eligible patients were available for follow-up. There were 14 Shatzker VI and 4 V fractures. Seven fractures were open. Average follow-up was 28.2 months. All fractures united. There were three cases of delayed union, all progressed to union following additional procedures and bone grafting. There were no cases of osteomyelitis, septic arthritis or deep vein thrombosis. Seven patients had Knee Society Clinical Rating Scores of good/excellent (38.9%), and 11 had fair/poor scores (61.1%). Abnormal mechanical axes and multiple co-morbid injuries were associated with poorer outcomes. Although SF-36 scores were lower in the study group compared to matched population norms, 15 of 18 patients had full or partial return to pre-injury levels of functioning.


CONCLUSIONS
Fine-wire fixation with limited internal fixation is a satisfactory method of managing complex high-energy fractures of the tibial plateau where soft tissue injury and bony comminution make traditional techniques of open reduction and internal fixation unsuitable.
Chin
Terence Y P
TY
Department of Orthopaedics and Trauma, The Alfred Hospital, Commercial Road, Prahan, Melbourne, Victoria 3135, Australia. tchin03@ihug.com.au
Bardana
David
D
Bailey
Michael
M
Williamson
Owen D
OD
Miller
Russell
R
Edwards
Elton R
ER
Esser
Max P
MP
D000328:Adult; D000368:Aged; D001864:Bone Wires; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D005596:Fractures, Closed / Q000534:rehabilitation* / Q000601:surgery; D005597:Fractures, Open / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013530:Surgical Wound Infection; D013978:Tibial Fractures / Q000534:rehabilitation* / Q000601:surgery