title: Treatment of complicated tibial plateau fractures with dual plating via a 2-incision technique.
abstract: The operative treatment of complicated bicondylar fractures of the tibial plateau remains a challenge to most surgeons. This retrospective study was designed to evaluate the clinical and radiological outcomes of dual plating via a 2-incision technique for the repair of complicated bicondylar tibial plateau fractures. A series of consecutive patients with bicondylar tibial plateau fractures treated by open reduction and internal fixation with a double buttress plate or a combination of locking plate and buttress plate via a 2-incision technique between March 2004 and March 2008 were retrospectively analyzed. Radiological and clinical results and complications of the 2 different fixation methods were compared. Seventy-nine patients matching the criteria of this study were followed up for at least 24 months. All of the fractures healed, with 3 cases of deep infection, 7 cases of secondary loss of reduction, 3 cases of secondary loss of alignment, and 10 cases of knee instability. At 24-month follow-up, mean Hospital for Special Surgery scores were 77.8±9.4 and 79.0±7.9 in the double buttress plate group and combination group, respectively. No significant differences in clinical or radiographic outcomes were found between the 2 groups, except that the combination group needed less bone graft. Dual plating with 2 incisions provided good exposition for the reduction and fixation of complicated bicondylar tibial plateau fractures. Using a combination of locking plate and buttress plate reduced the amount of bone graft compared with the double buttress plate technique.
authors.affiliation: Department of Orthopaedic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi Province, PR China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhang
authors.forename: De-gang
authors.initials: DG
authors.lastname: Fan
authors.forename: Bao-an
authors.initials: BA
authors.lastname: Ma
authors.forename: Si-guo
authors.initials: SG
authors.lastname: Sun
mesh_terms: D000328:Adult; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008297:Male; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D016896:Treatment Outcome