Abstract
BackgroundTo explore the epidemiological characteristics, clinical characteristics, treatment strategies, and clinical results of non-dislocated hyperextension tibial plateau fracture.MethodA total of 25 cases of non-dislocated hyperextension tibial plateau fracture patients were collected (12 males and 13 females), aged 27–79 years. Preoperative tibial plateau posterior slope angle was − 10~0° (average − 5.2°). Preoperative MRI showed 5 cases of MCL injury, 3 cases of PLC complex injury, and 2 cases of PLC + PCL injury. The change of tibial plateau posterior slope angle was more than 10° in patients with ligament injury, and the patients with a tibial plateau posterior slope angle change less than 10° had no ligament injury; 6 patients with simple column fracture had a ligament injury, 2 patients with bilateral column fracture had a ligament injury, and 2 patients with three column fracture had a ligament injury.ResultsPatients were followed up for 12–24 months (average 16.4 months). The operative time was 65–180 min (average 124 min), and the blood loss was 20–200 ml (average 106 ml). The plate was placed on the anterior part of tibial plateau. Evaluation of postoperative fracture reduction was as follows: 20 cases reached anatomic reduction, 5 cases reached good reduction (between 2 and 5 mm articular surface collapse), and the excellent rate of fracture reduction was 100%. The fracture healing time was 3–6 months (average 3.3 months). The postoperative knee Rasmussen score was 18–29 (average 24.9), and the postoperative knee joint mobility was 90–130° (average 118°). Two patients suffered superficial infection.ConclusionsThe main imaging characteristic of “non-dislocated hyperextension tibial plateau fracture” is the change of tibial plateau posterior slope angle. The injury of single anteromedial column/anterolateral column fracture is easy to combine with “diagonal” injury, and when the tPSA changes more than 10°, it is easy to be combined with ligament injury. By reducing the joint articular surface and lower limb force line, repairing the soft tissue structure, and reconstructing the knee joint stability, we can get satisfactory results.Trial registrationIt was a retrospective study. This study was consistent with the ethical standards of the Second Affiliated Hospital of Zhejiang University Medical College and was approved by the hospital ethics committee and the trial registration number of our hospital was 20180145.
Highlights
To explore the epidemiological characteristics, clinical characteristics, treatment strategies, and clinical results of non-dislocated hyperextension tibial plateau fracture
The injury of single anteromedial column/anterolateral column fracture is easy to combine with “diagonal” injury, and when the tPSA changes more than 10°, it is easy to be combined with ligament injury
More and more attention is paid to the tibial plateau fracture injury mechanism at present, it is clear that tibial plateau fracture injury mechanism can carry out targeted reduction and treatment of plateau fracture, and the existing mechanism of injury speculation is generally based on Luo CF’s three-column theoretical classification [1, 2]
Summary
To explore the epidemiological characteristics, clinical characteristics, treatment strategies, and clinical results of non-dislocated hyperextension tibial plateau fracture. According to the three-column theoretical classification, the tibial plateau fracture injury mechanism can be divided into two categories on sagittal plane, such as extension type injury when the posterior slope angle of tibial plateau (pTSA) decreases, and flexion type injury when the posterior slope angle of tibial plateau (pTSA) increases In practice, these two types of classification cannot completely classify the plateau fracture. Some tibial plateau fractures are caused by axial violence when the knee joint is hyperextended, resulting in the collapse of the anterior tibial plateau and the posterior soft tissue damage This type of injury is relatively special, and the injury mechanism and treatment plan are different from other type plateau fractures, which are generally referred to as “hyperextension tibial plateau fracture”
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
