title: Weight-bearing-induced displacement and migration over time of fracture fragments following split depression fractures of the lateral tibial plateau: a case series with radiostereometric analysis.
abstract: We investigated the stability of seven Schatzker type II fractures of the lateral tibial plateau treated by subchondral screws and a buttress plate followed by immediate partial weight-bearing. In order to assess the stability of the fracture, weight-bearing inducible displacements of the fracture fragments and their migration over a one-year period were measured by differentially loaded radiostereometric analysis and standard radiostereometric analysis, respectively. The mean inducible craniocaudal fracture fragment displacements measured -0.30 mm (-0.73 to 0.02) at two weeks and 0.00 mm (-0.12 to 0.15) at 52 weeks. All inducible displacements were elastic in nature under all loads at each examination during follow-up. At one year, the mean craniocaudal migration of the fracture fragments was -0.34 mm (-1.64 to 1.51). Using radiostereometric methods, this case series has shown that in the Schatzker type II fractures investigated, internal fixation with subchondral screws and a buttress plate provided adequate stability to allow immediate post-operative partial weight-bearing, without harmful consequences.
authors.affiliation: Department of Orthopaedics and Trauma, Royal Adelaide Hospital, North Terrace, Adelaide 5000, Australia. bogdansolomon@mac.com
authors.forename: L B
authors.initials: LB
authors.lastname: Solomon
authors.forename: S A
authors.initials: SA
authors.lastname: Callary
authors.forename: A W
authors.initials: AW
authors.lastname: Stevenson
authors.forename: M A
authors.initials: MA
authors.lastname: McGee
authors.forename: M J
authors.initials: MJ
authors.lastname: Chehade
authors.forename: D W
authors.initials: DW
authors.lastname: Howie
mesh_terms: D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012399:Rotation; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016474:Weight-Bearing