Comparison of the pre-shaped anatomical locking plate of 3.5 mm versus 4.5 mm for the treatment of tibial plateau fractures.
OBJECTIVE
Treatment of tibial plateau fractures is discussed. A retrospective comparative study of fractures treated with an anatomical locking plate of 4.5 mm or 3.5 mm. Our hypothesis is that the 3.5 mm plates give an equivalent hold of fractures with comparable results and better clinical tolerance.


METHODS
From May 2010 to October 2011, 18 patients were operated on using a 4.5-mm LCP™ anatomical plate (group A) and 20 patients received a3.5-mm LCP™ anatomical plate (group B). Groups were comparable. One fracture was open.


RESULTS
For the Group A, 14 patients had a follow up of 35.3 months and for the Group B, 16 patients had a follow up of 27 months. Mobility was comparable in both groups. The Hospital for Special Surgery (HSS) score was 86.4 versus 80.6, the Lysholm score was 83.6 versus 77 for groups A and B respectively. Consolidation was 3.25 months versus 3.35 months and mean axis was 183.1° versus 181.6° for groups A and B. Mechanical axes during revision were statistically different to the controlateral axes. One secondary displacement was noted in group A and one secondary displacement in group B. Group A had eight patients reporting discomfort with the material versus three in group B (p < 0.05).


CONCLUSIONS
The hypothesis is proven. In regards to the results, there is no significant difference between the two groups but the clinical tolerance was better in group B. More time is needed in the long term to better evaluate these severe fractures.
Orthopedics, Hopital de Hautepierre, Strasbourg, France. matthieu.ehlinger@chru-strasbourg.fr.
Matthieu
M
Ehlinger
Orthopedics, Hopital de Hautepierre, Strasbourg, France.
Benjamin
B
Adamczewski
Orthopedics, Hopital de Hautepierre, Strasbourg, France.
Michel
M
Rahmé
Orthopedics, Hopital de Hautepierre, Strasbourg, France.
Philippe
P
Adam
Orthopedics, Hopital de Hautepierre, Strasbourg, France.
Francois
F
Bonnomet
D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
Articular fracture; Fracture; Locking plate; Proximal tibia