Dual Plate Fixation Compared with Hybrid External Fixator Application for Complex Tibial Plateau Fractures

Jae-Sung Lee; Yong-Beom Park; Han-Jun Lee

doi:10.12671/jkfs.2008.21.2.124

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Lee, Park, and Lee: Dual Plate Fixation Compared with Hybrid External Fixator Application for Complex Tibial Plateau Fractures

Original Article

Journal of the Korean Fracture Society 2008; 21(2): 124-129.

Published online: 30 April 2008

DOI: https://doi.org/10.12671/jkfs.2008.21.2.124

Dual Plate Fixation Compared with Hybrid External Fixator Application for Complex Tibial Plateau Fractures

Jae-Sung Lee, M.D., Yong-Beom Park, M.D., Han-Jun Lee, M.D.

Department of Orthopedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea.

Address reprint requests to: Han-Jun Lee, M.D. Department of Orthpedic Sugery, Yong-San Hospital, 65-207, Hangangro 3-ga, Yongsan-gu, Seoul 140-757, Korea. Tel: 82-2-748-9774(9563), Fax: 82-2-793-6634, gustinolhj@hanafos.com

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To cmpare the clinical results of complex tibial plateau fractures treated by hybrid external fixation and dual plate fixation.

Materials and Methods

We studied forty patients with Schatzker type V and VI fractures respectively and selected twenty seven patients who were followed at least one year between January 2000 and December 2005. We evaluated the clinical results in which fourteen fractures with hybrid external fixation were compared with thirteen fractures with dual plate fixation. The clinical results were evaluated according to Knee Society Clinical Rating System and the statistical analysis was performed by Student t-test.

Results

There were no significant differences in terms of bone union time (average union time: dual plate fixation 13.8 weeks, hybrid external fixation 14.2 weeks). The quality of osseous reduction was superior in the fractures with dual plate fixation than those with hybrid external fixation. There were significant differences in functional score (average functional score: dual plate fixation 73, hybrid external fixation 62), but not in average knee score.

Conclusion

The hybrid external fixation can be a useful modality for treatment of complex proximal tibial plateau fractures. But the good quality of the fracture reduction by dual plate fixation may be a indicator for favorable prognosis for satisfactory knee function.

Keywords: Tibial plateau fracture, Dual plate fixation, Hybrid external fixation

Figures and Tables

Fig. 1

(A) Preoperative radiograph of 47 years old male shows the Schatzker type VI fracture by traffic accident.

(B) The hybrid external fixation is performed and augmented by cannulated screws.

(C) The malunion is seen at postoperative fifteen months.

Fig. 2

(A) Preoperative radiograph of 53 years old male shows the Schatzker type V fracture by traffic accident.

(B) Preoperative CT shows severe comminution and displacement of articular surface.

(C) The postoperative radiograph shows anatomical reduction of joint line.

(D) The patient has satisfactory knee function at postoperative thirteen months.

Table 1

Cause of injuries

Table 2

The numbers of malunion

Table 3

Outcomes of the Knee Society Clinical Rating System

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