[Reconstruction of malunited fracture of tibial plateau].

OBJECTIVE

To explore the treatment of the malunited fracture of the tibial plateau.

METHODS

From June 2000 to June 2005, reconstruction was performed on 29 patients (18 males, 11 females; age, 19-43 years, average, 31.6 years) with the malunited fracture of the tibial plateau. The injury duration ranged from 2.5 months to 2 years, averaged 9.7 months. After the injury, the plaster external fixation was performed on 8 patients and operation was performed on the other 21 patients. The operation was involved in the use of screws in 11 patients, anatomic plates, Golf plates and allotype plates in 8 patients, external fixation braces in 2 patients. A complicating injury to the anterior cruciate ligament (ACL) was found in 4 patients, an injury to the posterior cruciate ligament (PCL) in 2 patients, an injury to both ACL and PCL in 1 patient, and an injury to the meniscus in 6 patients. Reestablishment was performed on 19 patients, high tibial osteotomy on 7 patients, and osteotomy of the half tibial metaphysis on 3 patients.

RESULTS

Base on the follow-up for 8 months to 3 years (average, 13.6 months), the comprehensively scoring assessment showed that an excellent result was achieved in 8 patients, good in 15, fair in 4, and poor in 1, with an excellent and good rate of 82.1%, according to the Hohl knee joint function assessment on the pain, active movement, motion range, stability, and self-assessment.

CONCLUSION

For the reconstruction of the malunited fracture of the tibial plateau, the satisfactory therapeutic effectiveness can only be achieved if the proper indications are identified and the suitable operative methods are adopted. The total knee replacement is only applicable to the elderly patient, and for the young patient, the reconstruction should be performed.