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KMID : 1144520180300030261
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Knee Surgery & Related Research
2018 Volume.30 No. 3 p.261 ~ p.268
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Staged Treatment of Bicondylar Tibial Plateau Fracture (Schatzker Type V or VI) Using Temporary External Fixator: Correlation between Clinical and Radiological Outcomes
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Ryu Seung-Min
Yang Han-Seok
Shon Oog-Jin
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Abstract
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Purpose: This study is to investigate clinical and radiological results of staged treatment using a temporary external fixator in bicondylar tibial plateau fractures (TPFs) and to evaluate correlation between prognostic factors and postoperative clinical outcomes.
Materials and Methods: Twenty-four bicondylar TPF patients were selected. All patients were operated by a temporary external fixator first and then open reduction and internal fixation with dual plating. Clinical and radiological outcomes were evaluated.
Results: The mean American Knee Society score (AKSS) was 85.3. The mean Western Ontario and McMaster Universities Osteoarthritis index was 11.2. The mean range of motion (ROM) was 123.4°. The mean medial tibial plateau angle (mTPA) was 88.3°, and the mean proximal posterior tibial angle (PPTA) was 8.4°. Compared with the uninjured limb, the mean difference of mTPA was 1.5° and that of PPTA was 4.0°. The difference of PPTA and the AKSS demonstrated negative correlation (p=0.007). Patients with normal mTPA showed better ROM than those with abnormal mTPA (p=0.041).
Conclusions: Staged treatment using a temporary external fixator in bicondylar TPFs showed good clinical and radiological outcomes. Surgeons should evaluate the reduction status intraoperatively by fluoroscopy and also refer to the uninjured limb radiologically.
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KEYWORD
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Tibia, Plateau, Bicondylar, Fracture, External fixator
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