PMID: 9186200Jun 1, 1997Paper

Treatment of tibial plateau fractures by limited internal fixation

Clinical Orthopaedics and Related Research
P J DuweliusT S Woll

Abstract

Seventy-five adults who sustained 76 tibial plateau fractures were treated according to a prospective protocol using instability in extension as the principal indication for operative fixation. Patients showing instability underwent closed manipulative reduction under fluoroscopic guidance. If significant joint depression persisted after reduction, elevation of the fracture was performed either from below using bone punches through a cortical window or via limited arthrotomy. Iliac crest bone graft was used to buttress depressed fractures. Fixation was then secured using 7-mm cannulated screws with washers or buttress plates and screws. Postoperatively, 58 of 76 knees were managed in a hinged knee brace, allowing the patient early range of motion and protected weightbearing for 8 weeks. Patients who were found to have a stable knee were treated with Bledsoe braces according to the postoperative protocol. In the 75 patients, 18 of the 76 knees were unsuitable for percutaneous screw fixation because of fracture complexity requiring plates, severe open injuries, or inadequate reductions with limited fixation had been done. A minimum followup of 12 months was obtained in 55 patients (range, 12-59 months). All fractures had healed a...Continue Reading

References

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Citations

Mar 28, 2008·International Orthopaedics·M R BansalD D Shukla
Dec 31, 2015·Journal of Orthopaedic Surgery·Sunil G KulkarniSuresh Kriplani
Feb 1, 2008·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Marc-Antoine RousseauPhilippe Hardy
Aug 31, 2018·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Richard E BuckleyC Ryan Martin
Nov 18, 2000·Journal of Orthopaedic Trauma·F T BallmerH P Nötzli
Jun 15, 2000·Clinical Orthopaedics and Related Research·M S SirkinF F Behrens
Mar 30, 2005·Journal of Orthopaedic Trauma·Dimitris KatsenisElias Lambiris
Sep 5, 1998·Clinical Orthopaedics and Related Research·J T Watson, C Coufal
May 15, 2007·Clinical Orthopaedics and Related Research·Kanu S GoyalDaniel R Cooperman
Jun 21, 2017·EFORT Open Reviews·Ippokratis Pountos, Peter V Giannoudis
Nov 19, 2005·The Journal of Trauma·Jong-Keun OhJoo-Chul Ihn
Sep 5, 2002·The Journal of Bone and Joint Surgery. American Volume·Dennis P Weigel, J Lawrence Marsh
Mar 7, 2002·Journal of Orthopaedic Trauma·Greg L WestmorelandWilliam C Hutton
Jul 16, 2011·Journal of Orthopaedic Surgery and Research·George C BabisPanagiotis N Soucacos

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