title: Angular stable plates in proximal meta-epiphyseal tibial fractures: study of joint restoration and clinical and functional evaluation.
abstract: BACKGROUND
  The tibial plateau fractures involve one of the main weight bearing joints of the human body. The goals of surgical treatment are anatomical reduction, articular surface reconstruction and high primary stability. The aim of this study was to evaluate the clinical and functional outcomes after internal plate fixation of this kind of fractures.
  
  
  METHODS
  From January 2009 to December 2012, we treated 75 cases of tibial plateau fracture with angular stable plates. We used Rasmussen Score and the Knee Society Score for the clinical and functional evaluation. Twenty-five cases that underwent hardware removal had arthroscopic and CT evaluation of the joint.
  
  
  RESULTS
  No complications occurred. The clinical and functional evaluation, performed by the KSS and Rasmussen Score, highlighted the high percentage of good-to-excellent results (over 90 %). In every case, the range of motion was good with flexion >90°. Arthroscopy showed the presence of chondral damage in 100 % of patients. In all the cases, we found that X-ray images seem better than the CT images.
  
  
  CONCLUSIONS
  Angular stable plates allow to obtain a good primary stability, permitting an early joint recovery with an excellent range of motion. Avoiding to perform a knee arthrotomy at the time of fracture reduction could prove to be an advantage in terms of functional recovery. The meniscus on the injured bone should be preserved in order to maintain good function of the joint. X-ray images remain the gold standard in checking the progression of post-traumatic osteoarthritis.
authors.affiliation: IInd Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy. s.giannotti@med.unipi.it.
authors.forename: S
authors.initials: S
authors.lastname: Giannotti
authors.affiliation: IInd Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Giovannelli
authors.affiliation: IInd Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Dell'Osso
authors.affiliation: IInd Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Bottai
authors.affiliation: IInd Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Bugelli
authors.affiliation: IInd Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Celli
authors.affiliation: IInd Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Citarelli
authors.affiliation: IInd Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Guido
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D016059:Range of Motion, Articular; D013977:Tibia; D013978:Tibial Fractures / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Arthroscopy; Arthrotomy; CT scan; Internal fixation; Proximal tibial fracture