Abstract
The classic way of treatment of tibial plateau fractures with an extensive approach, opening of the knee and compressive internal fixation can lead to major complications such as infection, skin necrosis and knee stiffness. Here we present a less invasive and thus safer surgical technique, and its indications and results. Twenty patients with various types of fractures according to Schatzker’s classification (mainly V and VI) were treated during a time period of seven years. Surgical treatment usually consisted of a combination of percutaneous canulated screws with a hybrid external fixator. In three cases canulated screws were combined with a laterally applied anatomic locking plate. Patients were followed up for six months to three years postoperatively. Indications as well as intra and postoperative parameters such as surgical time, stability of fixation, blood loss, wound healing, infection, fracture healing and final result were studied. No major complications were recorded either early or later. The use of external οr less invasive internal fixation in combination with percutaneous canulated screws appears to be an adequate method for the treatment of most types of these fractures.
Highlights
Complex fractures of the tibial plateau are difficult to treat because an intra-articular component is accompaniedHow to cite this paper: Xarchas, K.C., Kyriakopoulos, G., Mavrolias, D., Oikonomou, L. and Petropoulos, I. (2015) Combined Use of Percutaneous Canulated Screws and External or Internal Fixationfor Less Invasive Treatment of Tibial Plateaux Fractures
Open management of these fractures, especially those classified as Schatzker VI, is usually followed by severe damage of the soft tissues, which may lead to wound complications after internal fixation [1]-[3]
The purpose of this study was to investigate whether our methods of less invasive treatment of severe tibial plateau fractures were as effective as the traditional ones
Summary
Complex fractures of the tibial plateau are difficult to treat because an intra-articular component is accompaniedHow to cite this paper: Xarchas, K.C., Kyriakopoulos, G., Mavrolias, D., Oikonomou, L. and Petropoulos, I. (2015) Combined Use of Percutaneous Canulated Screws and External or Internal Fixationfor Less Invasive Treatment of Tibial Plateaux Fractures. (2015) Combined Use of Percutaneous Canulated Screws and External or Internal Fixationfor Less Invasive Treatment of Tibial Plateaux Fractures. Open management of these fractures, especially those classified as Schatzker VI, is usually followed by severe damage of the soft tissues, which may lead to wound complications after internal fixation [1]-[3]. The use of an external hybrid ring fixator in those trauma situations is especially attractive for six basic reasons: less damage of anatomical structures (the fracture is aligned and stabilized without extensive soft tissue dissection), sufficient access for debridement and other procedures, mechanical effectiveness of the fixation, minimal loss of average of joint motion, early weight bearing and overall less complications [4]. In cases where a hybrid fixator cannot be used, a combination of canulated screws with a lateral anatomic locking plate applied, according to the rules of less invasive internal fixation, can be a good option [5]
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