Mid- and long-term surgical effect of tibial plateau fractures.

Abstract

Objective To analyze the mid- and long-term surgical effect of tibial plateau fractures, and to explore the factor that affected the curative effect. Methods The clinical data of 43 with tibial plateau fractures (from May 1995 to November 2004) was retrospectively reviewed. All fractures were classified according to the Schatzker classification. There were 25 men and 18 women, with the mean age of 47.8 years (26 to 73 years). Thirty six had isolated fractures and seven had multiple fractures. After 57.4 months follow-up was done in all 43 patients. Functional Results of these were graded with self-evaluation of the Macnab scores and the Lysholm scores. Radiologic Results were graded with the Rasmussen score and Resnick-Niwoyama score to evaluate the reduction of fracture and the degradation of the knee. The joint space, and depressed height of articular surface were measured. Statistical analysis was performed by means of the sofeware SPSS11.5. Results According to the MacNab score, the with tibial plateau fractures average degree of satisfaction was 60%, and along with a mean knee ROM from 0° to 113°. Func-tional Results showed a mean Lysholm score of 83.1 points (range, 17-98 points). According to the stepwise multiple regression analysis, in the monoeondylar fractures of the tibial plateau, the Lyshoha scores was connection with the joint space and depressed height of articular surface, and the relationship was negative correlation. The Lyshoha score was negative correlation with depressed height of articular surface and articu-lar gaps. Monoeondylar fractures showed statistically significant better functional Results compared to bi-condylar fractures. In Radiologic result of mean Rasmussen score was 14 points (10-18 points). In 81.4% (35/43 cases)of the patients injuried knees arise secondary osteoarthritis, and 23.3%(10/43 cases) uninjured side happened osteoarithritis. Conclusion Mid and long-term Results after open reduction and internal fixa-tion for tibial plateau fractures are effeeted by depressed height, articular gaps and age. At the same time monocondylar fractures will get better recovery than bicondylar fractures. Key words: Tibial fractures; Fracture fixation, internal; Treatment outcome