title: Use of a raft construct through a locking plate without bone grafting for split-depression tibial plateau fractures.
abstract: OBJECTIVE
  To review the outcome after open reduction and internal fixation using a periarticular raft construct through a locking plate without bone grafting for split-depression tibial plateau fractures.
  
  
  METHODS
  Records of 38 knees in 31 men and 7 women aged 25 to 75 (mean, 42.7) years who underwent open reduction and internal fixation using a periarticular raft construct through a locking plate without use of a bone graft or bone substitute for split-depression (>5 mm) proximal tibial plateau fractures (Schatzker type II or AO/OTA type 4.1 B3) were reviewed. The integrity of the articular surface was assessed using radiographs. The Rasmussen radiological score and clinical score, the Lysholm knee score, and the Tegner activity score were also assessed.
  
  
  RESULTS
  The mean follow-up period was 22.8 (range, 6-36) months. All patients achieved bone union after a mean of 13.2 (range, 8-26) weeks. The mean range of motion was 118º (range, 100º-130º). The Rasmussen radiological score was excellent in 27 patients, good in 9, and fair in 2. The Rasmussen clinical score was excellent in 15 patients, good in 21, and fair in 2. The Lysholm knee score was excellent in 26 patients, good in 8, and fair in 4. 32 of the 38 patients recovered to their preoperative Tegner activity scores. Only one patient with severe comminution had loss of reduction after full weightbearing.
  
  
  CONCLUSIONS
  Fixation using a periarticular raft construct through a locking plate without use of a bone graft or bone substitute for split-depression proximal tibial plateau fractures is a viable option.
authors.affiliation: Department of Orthopaedics, Post-Graduate Institute of Swasthiyog Pratishthan, Miraj, India.
authors.forename: Sunil  G
authors.initials: S
authors.lastname: Kulkarni
authors.forename: Ravishanker
authors.initials: R
authors.lastname: Tangirala
authors.forename: Shekhar P
authors.initials: SP
authors.lastname: Malve
authors.forename: Milind G
authors.initials: MG
authors.lastname: Kulkarni
authors.forename: Vidisha S
authors.initials: VS
authors.lastname: Kulkarni
authors.forename: Ruta M
authors.initials: RM
authors.lastname: Kulkarni
authors.forename: Suresh
authors.initials: S
authors.lastname: Kriplani
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D016025:Bone Transplantation; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D017102:Fracture Healing; D006801:Humans; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome
keywords: bone substitutes; fracture fixation, internal; tibial fractures; weight-bearing