New Approaches to Systematization and Treatment of Impression Monocondylar Tibial Plateau Fractures

Abstract

Treatment results for 109 patients (mean age 56 ± 1.7 years) with monocondylar impression tibial plateau fractures (ITPF) are presented. Patients from the control group (n=63) were operated on during the period from 2008 to 1010, patients from the main group (n=46) - from 2011 to 2013. Patients from the main group were treated with regard for injury localization relative to plateau center according to proposed operational classification of impression fractures (by CT data) and algorithm to choose the osteosynthesis technique depending on the anatomic and morphologic peculiarities of the intra-articular injury. In patients from the main group the evaluation by Rasmussen scale 36 months after intervention showed excellent results in 15 (38.4%), good - in 22 (56.4%), satisfactory - in 5 (12.8%) of patients, no poor results were recorded, and in patients from the control group - in 6 (11.5%), 8 (15.3%), 36 (69.3%) and 3 (5,8%) patients, respectively. Three (7.6%) complications (secondary displacement of fragments (2), knee contracture (1)) were observed in the main group, and 11 (20.9%) in the control group (20.9%) - local infectious inflammatory process (4), secondary displacement of plateau fragments (6), condylar sag (1). Perfected tactics of treatment of patients with ITPF enabled to achieve 3.48 times more excellent and good results (p<0.05).