Prospective follow-up of a simple arthroscopic-assisted technique for lateral tibial plateau fractures: results at 5 years.
This study reports the 5-year clinical and radiological outcomes of a simple arthroscopic-assisted technique for Schatzker types II and III tibial plateau fractures, without bone grafting. Forty six patients (46% males, 54% females, average age 48 years, SD 13.6 years), with tibial plateau fractures Schatzker types II (41%) and III (59%), underwent an arthroscopic-assisted technique conceived to use a compacted cancellous bone graft, taken from the medial metaphyseal side of the tibia, and a percutaneous fixation. The patients were prospectively followed-up at 1, 3 and 5 years from surgery. Independent assessments were carried out using Knee Society Score, HSS score and Rasmussen's clinical and radiological scores. At 5-year follow-up patients underwent a weight-bearing radiograph of both limbs. At last follow-up evaluation Knee Score (average 93.2, SD 7.7) was excellent in 37 patients (80%), good in six (13%), fair in three (7%). Function Score (average 94.8, SD 8.51) was excellent in 38 patients (83%), good in five (11%), fair in three (6%). HSS score (average 93.4, SD 8.23) was excellent in 41 patients (89%), good in five (11%). The average Rasmussen clinical score was 28.2 (SD 1.4). The radiological Rasmussen score was excellent in five patients (11%), good in 39 (85%) and fair in two (4%). In the weight-bearing radiographs a valgus deviation was present in four patients (8.7%). This technique has outcomes encouraging and comparable to the results of other techniques that use either iliac crest graft or bone substitutes.
University of Turin, Department of Orthopaedics and Traumatology, Umberto I Hospital, Turin, Italy.
Roberto
R
Rossi
Davide Edoardo
DE
Bonasia
Davide
D
Blonna
Marco
M
Assom
Filippo
F
Castoldi
D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D001858:Bone Nails; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome