[Reconstruction of the collapse tibial plateau fracture by injectable artificial bone combined with supportive plate fixation].
OBJECTIVE
To observe the effective of the injectable artificial bone combined with plate fixation for reconstructing the collapse tibial plateau fracture.


METHODS
From June 2005 to January 2008,21 cases of collapse tibial plateau fracture of type Schatzker II, III were treated by injectable calcium sulfate bone substitute combined with supportive plate reconstruction including 16 males and 5 females with an average age of 35.3 years ranging from 27 to 62 years. The disease course was from 3 to 7 days (means 4 days). According to Schatzker classification, there were 17 cases of type II, 4 of type III. All patients preoperatively underwent radiography, CT scanning and three-dimensional reconstruction in order to accurately understand the extent of fracture and fracture collapse and the shattered fragments of the flip direction. All the fracture with collapse > 3 mm, without joint degeneration were selcected for surgical treatment. The knee joint function after fracture healing and recovery were evaluated by Lysholm scoring.


RESULTS
All patients were followed-up for from 6 months to 2.5 years (means 1.5 years). The X-ray films and features of all fractures showed anatomic reduction or near anatomic reduction, except one case of grade II severe comminuted fracture occurred a high degree of loss and platform reset ineffective after 6 months. The Lysholm scoring of knee function showed that the mean score was (88.3 +/- 5.2). The results were excellent in 12 cases,good in 7 cases, fair in 2 cases.


CONCLUSIONS
Minimally invasive injectable calcium sulfate bone combined with plate fixation for reconstructing the collapse tibial plateau fracture of type II, III can effectively prevent the further loss after reduction, to improve the long-term results. Minimally invasive injectable calcium sulfate as an artificial bone substitute materials has good prospects for clinical application.
Guo
Rui
R
Department of Orthopaedics, Changhai Hospital Affiliated, Second Medical University of PLA, Shanghai 200433, China.
Cao
Lie-Hu
LH
Tong
Feng
F
Zhang
Chun-Cai
CC
Su
Jia-Can
JC
D000328:Adult; D001860:Bone Plates; D018786:Bone Substitutes / Q000008:administration & dosage*; D002130:Calcium Phosphates / Q000008:administration & dosage*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D013978:Tibial Fractures / Q000601:surgery*
D018786:Bone Substitutes; D002130:Calcium Phosphates; C020243:calcium phosphate