Chinese Journal of Tissue Engineering Research ›› 2014, Vol. 18 ›› Issue (26): 41796-4184.doi: 10.3969/j.issn.2095-4344.2014.26.015

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Stability of dual-incision double-plate fixation versus locking plate fixation for tibial plateau fracture 

Li Shi-fang, Sun Jian, Zhou Dao-zheng   

  1. First Ward, Department of Orthopedic Surgery, People’s Hospital of Kai County, Chongqing 405400, China
  • Online:2014-06-25 Published:2014-06-25
  • Contact: Zhou Dao-zheng, Chief physician, First Ward, Department of Orthopedic Surgery, People’s Hospital of Kai County, Chongqing 405400, China
  • About author:Li Shi-fang, Master, Associate chief physician, First Ward, Department of Orthopedic Surgery, People’s Hospital of Kai County, Chongqing 405400, China

Abstract:

BACKGROUND: Schatzker V, VI fracture often causes the injuries to cruciate ligament, collateral ligaments and meniscus. Moreover, the collapse and shifting were severe. The locking plate on one side cannot support the weight or obtain satisfactory reduction.
OBJECTIVE: To compare the effects and stability of the dual-incision double-plate fixation and knee midline incision locking plate fixation in the treatment of Schatzker V, VI tibial plateau fracture.
METHODS: A total of 76 patients with Schatzker V, VI tibial plateau fracture were respectively treated with locking plate fixation (n=38) and dual-incision double-plate fixation (n=38). Fracture reduction and healing were assessed using anteroposterior and lateral radiographs. Varus angle and medial caster angle of tibial plateau received biomechanical measurement.
RESULTS AND CONCLUSION: Hospital stay and postoperative load time were significantly less in the dual-incision double-plate fixation group than in the locking plate fixation group (P < 0.05). No significant difference in healing time was detected between locking plate fixation and dual-incision double-plate fixation groups (P > 0.05). The number of complications, such as ankylosis, fracture delayed union, pin tract infection,  
delayed union, varus deformity, was significantly fewer in the dual-incision double-plate fixation group than in the locking plate fixation group (P < 0.05). There were no significant differences in the fracture of loosening, knee instability, wound infection, skin necrosis, bone necrosis and nonunion between the dual-incision double-plate fixation and locking plate fixation groups (P > 0.05). Postoperative Rasmussen classification was significantly better in the dual-incision double-plate fixation group than in the locking plate fixation group (P < 0.05). Experimental results indicated that the clinical efficacy of the dual-incision double-plate fixation is superior to that of the anterior cruciate midline incision locking plate fixation in the treatment of Schatzker V, VI type tibial plateau fractures. The dual-incision double-plate fixation has more biomechanical stability.


中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


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Key words: tibia, tibial fractures, bone transplantation, ankylosis, internal fixators, biomechanics

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