Combination of fine wire fixation and limited internal fixation for high-energy tibial plateau fractures: functional results at minimum 5-year follow-up.
OBJECTIVE
To assess knee function and the development of knee arthrosis, at 3 and 5 years postoperatively, in high-energy tibial plateau fractures that were treated with minimal internal fixation augmented by small wire circular frames.


METHODS
Level II trauma hospital.


METHODS
: Retrospective study.


METHODS
Between October 1988 and December 1999, 145 consecutive high-energy tibial plateau fractures were treated with hybrid fixation including small wire circular or hybrid frames, minimal internal fixation, and occasionally provisional extension of the external fixation to the distal femur. One hundred twenty-seven patients with 129 fractures (89%) were included in the study. There were 68 (53%) C1, 20 (15%) C2, and 41 (32%) C3 fractures. Forty-seven (36.5%) of the total were open fractures. Clinical, subjective, objective, and radiographic results were evaluated at the time of union, at a minimum 3 years postoperatively, and at final minimum follow-up of 5 years.


RESULTS
Results were assessed according to the Honkonen-Jarvinen criteria. An excellent or good subjective result was noted in 106 fractures (82%) at a minimum 3-year follow-up, whereas an excellent or good score was achieved in 101 fractures (78%) at a minimum 5 years. A statistically significant deterioration (P = 0.001) of the post-traumatic radiographic arthritis was recorded at 5 years postoperatively.


CONCLUSIONS
High-energy tibial plateau fractures treated with minimal internal fixation augmented by small wire external fixation frames yielded a high percentage of cases exhibiting radiographic post-traumatic arthritis. However, because all the objectives of fracture treatment seemed to be obtained, the functional results remain satisfactory over time.
Katsenis
Dimitris
D
Orthopaedic Department, Argos General Hospital, Argos, Greece. katsenis@yahoo.com
Dendrinos
George
G
Kouris
Antonis
A
Savas
Nikos
N
Schoinochoritis
Nikos
N
Pogiatzis
Kostas
K
D001864:Bone Wires; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D017102:Fracture Healing; D006801:Humans; D016268:Internal Fixators; D008297:Male; D020127:Recovery of Function; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome