A Novel Method of the Treatment for Posterolateral Tibial Plateau Fractures

Dong Ren; Yueju Liu; Yanxi Chen; Jian Lu; Zhaohui Song; Bing Zhou; Pengcheng Wang

doi:10.1055/s-0039-1688918

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2020; 33(10): 1010-1019
DOI: 10.1055/s-0039-1688918

Original Article

A Novel Method of the Treatment for Posterolateral Tibial Plateau Fractures

Dong Ren

¹Orthopaedic Trauma Service Center, Third Hospital of Hebei Medical University, Major Laboratory of Orthopaedic Biomechanics in Hebei Province, Shijiazhuang, Hebei Province, China

,

Yueju Liu

¹Orthopaedic Trauma Service Center, Third Hospital of Hebei Medical University, Major Laboratory of Orthopaedic Biomechanics in Hebei Province, Shijiazhuang, Hebei Province, China

,

Yanxi Chen

²Department of Orthopedic Trauma, East Hospital, Tongji University School of Medicine, Shanghai, China

,

Jian Lu

¹Orthopaedic Trauma Service Center, Third Hospital of Hebei Medical University, Major Laboratory of Orthopaedic Biomechanics in Hebei Province, Shijiazhuang, Hebei Province, China

,

Zhaohui Song

¹Orthopaedic Trauma Service Center, Third Hospital of Hebei Medical University, Major Laboratory of Orthopaedic Biomechanics in Hebei Province, Shijiazhuang, Hebei Province, China

,

Bing Zhou

³Department of Orthopaedic Surgery, Gaoyou Hospital, Soochow University, Gaoyou, Jiangsu, China

,

Pengcheng Wang

¹Orthopaedic Trauma Service Center, Third Hospital of Hebei Medical University, Major Laboratory of Orthopaedic Biomechanics in Hebei Province, Shijiazhuang, Hebei Province, China

› Author Affiliations

Abstract

Reduction and fixation of posterolateral tibial plateau fracture via a posterolateral approach is challenging, and the posterolateral approach itself may injure the posterolateral ligament complex of the knee and can result in knee instability. We developed a new curved support plate (CSP) that can pass, via traditional anterolateral approach, through the superior tibiofibular interval and effectively support the posterolateral fragments. The purpose of our study was to determine the biomechanical reliability of the new plate and report the preliminary efficacy of the CSP for posterolateral tibial plateau fracture. In the biomechanical experiment, 40 synthetic tibias were used to create posterolateral shearing tibial fracture models, which were randomly assigned to groups A to D. Vertical displacement of the posterolateral fragments was measured under axial loads of 500 to 1,500 N. The new plate and 3.5-mm lateral locking plate exhibited similar control over fragment displacement. From June 2016 to August 2017, eight patients with posterolateral tibial plateau fracture underwent treatment with the CSP. Hospital for Special Surgery (HSS) knee score, knee flexion and extension ranges of motion, and complications were recorded to evaluate treatment effects. Eight patients (five men and three women, mean age 44 years [range, 23–66 years]) were enrolled in the study. Mean follow-up time was 13 months (range, 7–19 months). All patients achieved radiographic bone union by 3.3 months (range, 3–4 months) postoperatively. There were no complications of neurovascular injury, deep vein thrombosis, infection, and implant loosening throughout the follow-up period. At final follow-up, mean HSS score was 92.6 (88–96), with a mean knee flexion of 131.25 degrees (120–135 degrees) and a mean knee extension of 1 degree (0–5 degrees). Fixation of posterolateral tibial plateau fracture was easily and successfully achieved using our newly designed CSP, which may provide a new choice for posterolateral tibial plateau fractures.

Keywords

CSP - anterolateral approach - posterolateral tibial plateau fracture

Full Text

References

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