Plateau fracture

Schatzker III tibial plateau fractures (TPF) reduction and stabilization still represents a challenging procedure. We present an alternative, percutaneous surgical technique. With an antero-medial transverse incision at the level of the tibial metaphysis, under fluoroscopic control, an osteotome is advanced from medial to lateral, under the depressed fragments, reducing the articular surface of the lateral TP anatomically, without creating a significant void and preserving the lateral wall. Final fixation is achieved with screws placed from lateral to medial in a percutaneous fashion, parallel to the articular surface to hold fragments in a rafting way...

PURPOSE: The aim of this study was to analyse the functional outcome and the conversion rate to total knee arthroplasty (TKA) after surgically treated tibial plateau fractures (TPF). METHODS: All patients undergoing surgical treatment of TPF at a single institution between January 2003 and December 2019 were retrospectively reviewed. The Knee injury and Osteoarthritis Outcome Score (KOOS) and Tegner activity scale (TAS) were collected. The conversion rate to TKA was examined 2, 5, 7 and 10 years after surgical treatment of TPF...

Neck pain is a multifactorial condition, and one common cause is cervical spine injury related to motor vehicle collision (MVC). Injuries from MVCs range from whiplash to cervical spine fracture and can manifest in various ways including neck stiffness, decreased range of motion, and neurological deficits. One method of management currently underutilized is osteopathic manipulative treatment (OMT), which can be used to treat pain and range of motion deficits resulting from MVCs. While a few studies in the literature have documented a statistically significant benefit of OMT in chronic pain syndromes, there is little data on its effectiveness in treating patients after MVCs...

OBJECTIVES: Prior studies have demonstrated elevated inflammatory cytokine concentrations in the synovial fluid of articular fracture patients post-injury. Similarly, CT-based fracture energy measurements have been correlated to PTOA risk after pilon fracture. The purpose of this study was to determine the associations between synovial fluid cytokine levels, fracture energy, and overall trauma to the body in articular fracture patients. METHODS: Acute tibial plateau, tibial plafond, and rotational ankle fracture patients were prospectively enrolled from December 2011 through January 1, 2019...

Lateral platform collapse in fixations of lateral tibial plateau fractures (TPFs) using either double-lag screws fixation (DSF) or locking-plate fixation (LPF) is not rare. This study aimed to explore the effect of enhancing the interfragmentary compression force (IFCF) on fixation stability in lateral TPFs in normal and osteoporotic bones using finite element analysis. Finite element models of DSF in normal bone and LPF in normal and osteoporotic bones were established to simulate the fixations of lateral TPF...

OBJECTIVES: To evaluate the timing of definitive fixation of tibial plateau fractures relative to fasciotomy closure with regards to alignment and articular reduction. METHODS: Design: Retrospective Case Series. SETTING: Four Level I trauma centers. PATIENT SELECTION CRITERIA: Patients with tibial plateau fractures with ipsilateral compartment syndrome treated with fasciotomy between 2006-2018 met inclusion criteria...

INTRODUCTION: Thoracolumbar vertebral fractures (TVFs) constitute frequent injuries with specific therapeutic challenges and remarkable implications for affected individuals. The aim of this study is to investigate the alteration of overall health-related quality of life (HRQoL) in patients with traumatic TVFs undergoing thoracolumbar fusion surgery. MATERIALS AND METHODS: A total of 72 patients with single-level traumatic thoracic or lumbar vertebral fractures (AO type A3 or A4) were enrolled in this prospective cohort study...

BACKGROUND: The transition from revision total knee arthroplasty (RTKA) to arthrodesis involves the replacement of cemented femoral and tibial stems with a modular nail designed for arthrodesis. This conversion process is associated with challenges such as bone loss, blood loss, and prolonged surgical durations. Effectively addressing these complexities through a less invasive surgical approach could be pivotal in enhancing patient outcomes and minimizing associated complications. CASE PRESENTATION: A 75-year-old white Caucasian female patient with a revision total knee arthroplasty (RTKA) performed with a modular uncemented rotating-hinge system, reporting an history of recurrent patellar dislocation, was referred to our institution after a fall resulting in periprosthetic tibial plateau fracture...

BACKGROUND: The Tibetan area is one of China's minority regions with a shortage of general practice personnel, which requires further training and staffing. This research helps to understand the current condition and demand for general practitioner (GP) training in Tibetan areas and to provide a reference for promoting GP education and training. METHODS: We conducted a cross-sectional survey using stratified sampling targeting 854 GPs in seven cities within the Tibetan Autonomous Region, utilizing an online questionnaire...

BACKGROUND: There are many difficulties in the reduction and fixation of the tibial plateau fractures involving posterolateral quadrant using general plates via traditional approaches. By imaging the area above the fibulae capitulum, this study was performed to investigate the feasibility of the trans-fibular-head approach and to design an ideal anatomical plate. METHODS: MRI and CT scans of the knee joint were collected from 205 healthy volunteers (103 males, 102 females)...

Introduction Treatment of osteoporotic vertebral fractures (OVFs) is a factor that affects the quality of life and should be considered during management. In patients with a single OVF and neurologic deficit, surgical procedures aiming at neural decompression with instrumented fusion should be considered in elderly individuals. Posterolateral instrumented fusion (PLF) constitutes a largely performed fusion surgery for patients featuring indications for fusion surgery. The aim of this study was to determine the safety, effectiveness, and impact on health-related quality of life (HRQoL) of PLF surgery in elderly patients diagnosed with a single OVF...

OBJECTIVE: Dual-plate fixation was thought to be the gold standard for treating complicated bicondylar tibial plateau fractures, yet it was found to be hard to accommodate the posterior column in three-column fractures. Currently, column-specific fixation is becoming more and more recognized, but no comprehensive investigation has been performed to back it up. Therefore, the objective of this study was to validate the importance of posterior column fixation in the three-column tibial fractures by a finite element (FE) analysis and clinical study...

Transarticular external fixation is primarily used for open fractures involving the joint. However, its biggest drawback is the potential forjoint dysfunction. The article reports a successful case with complex open tibial plateau fracture treated using locked plate external fixation technique during bone callus formation stage to replace transarticular external fixation. We present a case of a 55-year-old male who sustained a complex open fracture of the tibial plateau. In addition, he also suffered from multiple rib fractures, a fibula fracture, a clavicle fracture, hemorrhagic shock, and lung contusion...

PURPOSE: Weight-bearing (WB) radiographs are commonly used to judge stability of type B fibula fractures and guide the choice of treatment. Stable fractures can be treated conservatively, and unstable fractures surgically. The question is raised how much weight patients actually put on their broken ankle while making a WB radiograph. The current study will give insight in the actual amount of WB in WB radiographs. METHODS: In this retrospective cohort study, 57 patients with a type B fibula fracture with a medial clear space (MCS) < 6 mm on regular mortise (RM) view who underwent a WB radiograph were included...

INTRODUCTION: The reported incidence of infection related with tibial plateau fractures (IRTPF) ranges from 2 to 23%. This complication can result in catastrophic consequences such as deformity, post-traumatic osteoarthritis, chronic pain, loss of function, and substantial economic burdens on healthcare systems due to extended hospital stays and the resources required for treatment. Consequently, it is imperative to emphasize the identification of infection risk factors. METHODS: A retrospective case-control study was designed, encompassing patients who underwent surgery for tibial plateau fractures between 2015 and 2020...

Cementless unicompartmental knee arthroplasty (UKA) has a lower rate of radiolucency in postoperative follow-up than cemented UKA. However, the rate of tibial plateau fracture, one of the complications, has been reported to be higher in cementless UKA than in cemented UKA. We report four cases of postoperative tibial lateral condyle fractures after cementless Oxford UKA. Four patients underwent cementless Oxford UKA. Immediate postoperative radiography and CT showed no fracture lines. At five to six weeks postoperatively, MRI showed a fracture line from the intersection of the longitudinal and transverse tibial osteotomies through the lateral pinhole to the end of the lateral tibial diaphysis...

Bicondylar tibial plateau fractures are technically demanding fractures that have a high complication rate. We sought to review the recent literature with the aim to summarize the development of new classification systems that may enhance the surgeon's understanding of the fracture pattern and injury. We highlight the best methods for infection control and touch on new innovative solutions using 3D printer models and augmented mixed reality to provide potentially personalized solutions for each specific fracture configuration...

Ipsilateral hip and knee dislocation is a rare and complex injury that usually results from high-energy trauma. Only 14 cases were reported in the literature so far. We report the case of a 35-year-old man who presented with an ipsilateral right hip and knee dislocation after being involved in a road traffic accident. A contralateral floating knee was associated. The hip dislocation was associated to a posterior wall fracture of the acetabulum and a femoral head fracture. The knee dislocation was compound and associated with a patella fracture...

BACKGROUND: Bicondylar tibial plateau fractures pose many treatment challenges due to their complex fracture patterns and associated soft tissue compromise. We aim to evaluate outcomes of acute ORIF (aORIF) versus staged ORIF (sORIF) of high energy bicondylar tibial plateau fractures. METHODS: We retrospectively reviewed 186 patients at two high-volume Level I trauma centers. One hundred one patients underwent aORIF and 85 underwent sORIF between 2011 and 2019. Clinical outcomes of interest included operative time, wound dehiscence, superficial and deep infection, nonunion, flap coverage, arthrodesis, and early conversion to arthroplasty...

Tibial plateau fractures (TPFs) are orthopedic challenges with multiple injury modalities and clinical presentations. TPFs are often classified using the Schatzker classification system, which can dictate management. In our case, a 37-year-old male presented at an orthopedic specialty hospital with right knee pain after a fall from a truck ramp. X-rays and CT imaging demonstrated a comminuted bicondylar TPF in the emergency room with metaphyseal dissociation. The patient was placed in a knee immobilizer, made non-weight bearing, and scheduled for outpatient follow-up with a local orthopedic surgeon...