Complex tibial plateau fractures treated by locking compression plate combined with the bio-ceramic

Abstract

Objective To evaluate the clinical efficacy of treating complex tibial plateau fractures by locking compression plate (LCP) combined with the bio-ceramic.Methods From January 2010 to October 2011,43 patients with complex tibial plateau fractures were treated by LCP plus the bio-ceramic.They were 24 men and 19 women,19 to 77 years of age (average,41.2 years).By the Schatzker classification,25 cases were type Ⅴ and 18 type Ⅵ; by the three-column classification,29 cases were three-column fractures and 14 double-column fractures.Bilateral LCP fixation plus the bio-ceramic filling was performed in 16 patients with severe displacement and separation while single lateral or medial LCP fixation plus the bio-ceramic filling was performed in 27 patients without severe displacement or separation.Brace or plaster protection was continued for 4 to 6 weeks.X-ray follow-ups were conducted regularly.Progressive functional rehabilitation was encouraged gradually according to the fracture healing of the patients.Clinical efficacy was evaluated according to the knee functional scoring of the Hospital for Special Surgery (HSS) system.Results The operative time averaged 92 minutes,and the intraoperative blood loss averaged 220 mL.All patients were followed up for 5 to 20 months (average,8.0 months).Clinical fracture healing was achieved in 42 patients after 12 to 16 weeks postoperatively.Incision exudate was observed in 2 cases 3 days after operation but responded to one-week intensive care.One case of chronic osteomyelitis occurred but was cured after dressing changes and debridement.By HSS scores,20 cases were excellent,19 good,3 moderate and one poor,giving an excellent and good rate of 90.7％.Conclusion LCP plus the bio-ceramic is a good treatment of tibial plateau fractures,because it leads to fewer complications and high efficiency. Key words: Bone plates; Ceramics; Tibial fractures