THE RESULTS OF ELEVATION, GRAFTING AND INTERNAL FIXATION THERAPY IN TIBIAL PLATEAU FRACTURES
Hasan Hilmi MURATLI1, Halil Yalçın YÜKSEL1, Levent ÇELEBİ1, Ali BİÇİMOĞLU1, A Yalçın TABAK2
1Sağlık Bakanlığı Ankara Numune Eğitim ve Araştırma Hastanesi 3. Ortopedi ve Travmatoloji Kliniği
2Sağlık Bakanlığı Ankara Numune Eğitim ve Araştırma Hastanesi 5. Ortopedi ve Travmatoloji Kliniği
Keywords: Tibial Plateau Fractures, Internal Fixation, Autograft.
Introduction: Our purpose is to evaluate clinical and radiological results of elevation, grafting and internal fixation therapy in tibial plateau fractures retrospectively.
Patients and methods: 18 fractures of 17 patients that has been classified as B2 and B3 according to AO/ASIF classification were included in this study. Mean follow-up time was 32 (24 - 72) months. Avarage age was 44.6 (23-74). 13 (%72.2) of this fractures were lateral and 5 (%27.8) of them were medial. Avarage preoperative collaps was 11.78 (8-22) mm. Avarage preoperative condyler enlargement was measured as 12.05 (7-20) mm. 3 patients (%16.7) had varus-valgus instability over 10°. After the visualisation of articular surface collapsed parts were reduced and autografts were placed to the elevation site in all fractures. Fractures were internaly stabilised according to AO technique.
Findings: According to Hohl criteria average score was 80.5 (56-94). 3 (%16.7) cases resulted as excellent, 6 (%33.3) were good, 6 (%33.3) were moderate, 3 (%16.7) were bad. Evaluating our results we found that presence of fibula fractures, co-existing meniscal and ligamentous injuries, additional ipsilateral and bilateral lower extremity fractures, medial plateau fractures and late initiation of ROM exercises effect the results adversely. We have observed less than 50% of preoperative collaps in 14 (77.2%) and more than 50%in 4 (22.2%) patients 2 years postoperatively. In final follow up examination we have found that radiological values do not corolate with clinical evaluations.
Conclusion: We think that, elevation, grafting and internal fixation therapy applied in tibial plateau fractures showing excesive collaps provides a stabil, mobile and painfree joint effectively.