title: [Case-control study on operative treatment for complex tibial plateau fracture].
abstract: OBJECTIVE
  To explore optimal choice of surgical treatment and operative approach for closed complex tibial plateau fractures and its influencing factors.
  
  
  METHODS
  From January 2003 to January 2011, 95 patients with closed complex tibial plateau fractures were estimated Schatzker V and Vl, and treated with three different surgical methods. The methods included single plate through anterolateral incision (Group A, 22 cases), double plates through inside and outside incisions (Group B, 36 cases), and double plates through antero-midline incisions (Group C, 37 cases). There were 56 males and 39 females, ranged the age from 19 to 57 years (averaged, 36.3 years), 50 cases in left, 45 cases in right. According to Schatzker classification, 51 cases were type V, 44 cases were VI. The data of operation time, intraoperative blood loss, complications (infectious of wound, necrosis, bad incision, collapse fracture, loosen of internal fixation, fracture failure)and recovery of function of lower limb joint were collected.
  
  
  RESULTS
  There were no significant difference among three groups in operation time (P > 0.05); blood loss in group A was obvious better than other groups (P < 0.05); collapse of joint surface and failure rate of internal fixation in group A was higher than other groups (P > 0.05); Merchant score after 1 year were higher in group B, C than group A. For lower limb function, 10 cases got excellent results, 5 good, 4 fair and 3 poor in group A; 21 cases got excellent results, 11 good, 3 fair and 1 poor in group B; 23 cases got excellent results, 11 good,2 fair and 1 poor in group C.
  
  
  CONCLUSIONS
  The blood loss in group A was least, but fracture exposure and joint surface was not satisfactory, and stable fixation could not be achieved, the long-term result was not good. For fractures with double condyles and dislocated involved, double plates through inside and outside incisions or double plates through antero-midline incisions was suggested,which benefit good reduction of joint surface, stable fixation, and erlier exercise.
authors.affiliation: The Forth Department of Orthopaedics, the 98th Hospital of PLA, Huzhou 313000, Zhejiang, China. yx0501@yahoo.com.cn
authors.forename: Yun-Qin
authors.initials: YQ
authors.lastname: Xu
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.forename: Tu-Gang
authors.initials: TG
authors.lastname: Shen
authors.forename: Pei-Hua
authors.initials: PH
authors.lastname: Su
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.forename: You-Rong
authors.initials: YR
authors.lastname: Yao
authors.forename: Pan
authors.initials: P
authors.lastname: Deng
authors.forename: Zheng-Li
authors.initials: ZL
authors.lastname: Luo
authors.forename: Qiang-Qiang
authors.initials: QQ
authors.lastname: Wei
authors.forename: Yong
authors.initials: Y
authors.lastname: Tang
mesh_terms: D000328:Adult; D001860:Bone Plates; D016022:Case-Control Studies; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects / Q000379:methods*; D005596:Fractures, Closed / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013978:Tibial Fractures / Q000601:surgery*