Abstract
PurposeTo report the diagnosis, injury mechanisms, and imaging characteristics of hyperextension bicondylar tibial plateau fractures and examine the indications and feasibility of the modified anterior midline incision as a treatment strategy.MethodsWe performed a retrospective analysis of 11 cases of hyperextension bicondylar tibial plateau fractures who were treated with open reduction and internal fixation, predominantly via an anterolateral and posteromedialdouble incision or a modified anterior midline incision. Radiological and functional evaluations were performed.ResultsEleven patients were followed-up for a mean period of 11.5 months (range 3–24 months). The mean time to radiographic bony union was 12.5 weeks (range 10–26 weeks). At final follow-up, the average Rasmussen functional score was 26.8 (range 24 − 29); five patients had an excellent rating, and six a good rating. The average range of motion of the affected knees was 3.4–130° postoperatively. Fixation failure was not observed in any of the treated fractures.ConclusionHyperextension bicondylar tibial plateau fractures show a special Tiankeng-like collapse characteristic, while the changes in posterior tibial slope angle are easy to overlook. The modified anterior midline incision is a safe and effective approach for treatment of hyperextension bicondylar tibial plateau fractures with less rear displacement. Open reduction and double plating for the treatment of hyperextension bicondylar tibial plateau fractures provides excellent results.
Highlights
Hyperextension bicondylar tibial plateau fractures are a particular form of tibial plateau fracture with a low incidence [1]
In accordance with the injury mechanisms and radiological features, we suggest that this injury should be named “hyperextension bicondylar tibial plateau fractures.”
Of the 11 patients, three were accompanied by popliteal artery rupture or embolism, three lateral menisci ruptures were observed at surgery, and one lateral menisci was diagnosed by magnetic resonance imaging (MRI)
Summary
Hyperextension bicondylar tibial plateau fractures are a particular form of tibial plateau fracture with a low incidence [1] This is a Schatzker VI type tibial plateau fracture, it has distinct injury mechanisms, fracture morphology, and combined injuries. In accordance with the injury mechanisms and radiological features, we suggest that this injury should be named “hyperextension bicondylar tibial plateau fractures.” We defined this injury as a compression fracture of the anterior tibial plateau caused by over-extension force of the knee joint, The purpose of this study was to report the diagnosis, injury mechanisms, and imaging characteristics of hyperextension bicondylar tibial plateau fractures and to examine the indications and feasibility of the modified anterior midline incision as a treatment strategy In accordance with the injury mechanisms and radiological features, we suggest that this injury should be named “hyperextension bicondylar tibial plateau fractures.” We defined this injury as a compression fracture of the anterior tibial plateau caused by over-extension force of the knee joint, The purpose of this study was to report the diagnosis, injury mechanisms, and imaging characteristics of hyperextension bicondylar tibial plateau fractures and to examine the indications and feasibility of the modified anterior midline incision as a treatment strategy
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