Abstract:

BACKGROUND: When using single plate for treating complicated tibial plateau fractures, it can only provide one-end stability of tibial plateau, result in eccentrically braced frames and prone to angular deformity. On the other hand, using lateral branch plate but neglecting cortical bone integrity easily leads to knee joint internal inversion. Dual plating through two separate incisions can increase the strength of fixation, prevent lateral condyle collapse and avoid deformity of internal and external inversion after operation.
OBJECTIVE: To evaluate the clinical effects of treatment of complicated tibial plateau fractures with dual plating through two separate incisions.
METHODS: A total of 17 patients with complicated tibial plateau fractures were selected from Department of Orthopaedics, Central Hospital of Wuhan between February 2004 and May 2010. There were 11 males and 6 females, aged 19-54 years and mean age of 33.6 years; left knee in 9 cases, right knee in 8 cases. According to AO classification: type B in 5 cases, type C in 12 cases; according to Schatzker classification: type Ⅳ in 3 cases, type Ⅴ in 9 cases and type Ⅵ in 5 cases. Surgical treatment with dual plating was implemented when edema and soft tissue reaction subsided at 6-10 days after injury happened. All cases were received reduction and bone graft on operation, moreover exercises with CPM machine and non-weight-bearing walking with crutches to recover the function of knee joint went on gradually from the first day after operation.
RESULTS AND CONCLUSION: All patients were followed up for 8-72 months, an average of 25.9 months. Knee stiffness appeared in 1 case of old fractures of the tibial plateau after operation. Postoperative wound infection appeared in 1 case of open fractures was healed after treatment. Finally smooth articular surface of knee and normal limb lines appeared in all other cases. According to Merchant evaluation system, the knee function was excellent in 9 cases, good in 6 cases, fair in 1 case and poor in 1 case. The excellent and good rate was 88.2%. No material related adverse effect happened, which showed that dual plates have good biocompatibility.