Amin T K, Patel I, Jangad A H, Shah H, Vyas R P, Patel N V, Modi D R
Department of Orthopaedics, Smt. NHL Municipal Medical College, Ahmedabad, India.
Malays Orthop J. 2023 Mar;17(1):90-97. doi: 10.5704/MOJ.2303.011.
Proximal tibial plateau fractures are one of the major problems in orthopaedic surgery and are associated with high complication rates. Intra-articular proximal tibia plateau fractures represent approximately 1% of fractures in adults. Various modalities of proximal tibial plateau fracture management have been considered, ranging from simple external fixators in impending compartment syndrome to periarticular proximal tibia plates and inter-locking nails with poller screws. Purpose of this study is to determine clinical outcomes of proximal tibial plateau fractures treated with plate.
We did this study of proximal tibial plateau fracture according to Schatzker's classification treated with proximal tibial periarticular plates in 53 patients prospectively admitted at the author's institute from June 2018 to May 2020 with follow-up period of 6 months.
In our study, the average knee score was 89.30 (ranging from 79 to 93) and functional knee score was 97.92 (ranging from 75 to 100). Fifty-one (51) patients (96.23%) showed excellent results and 2 patients (3.77%) showed good results according to Knee Society Score, which suggest that internal fixation of proximal tibia plateau fracture with plating provides better results. Out of 53 patients, 9 patients had post-operative complications. Average radiological union was seen at 14 weeks.
Locking compression plate in proximal tibia plateau fractures act as a good biological fixation provide stable fixation, articular reduction and limb alignment even in difficult fracture situations. Fixation of proximal tibia plateau fractures with plate gives excellent to good knee society score, with satisfactory functional and radiological outcome.
胫骨近端平台骨折是骨科手术中的主要问题之一，且并发症发生率很高。成人关节内胫骨近端平台骨折约占骨折的1%。对于胫骨近端平台骨折的治疗，已经考虑了多种方式，从即将发生骨筋膜室综合征时的简单外固定器到关节周围胫骨近端钢板以及带拨钉的交锁髓内钉。本研究的目的是确定采用钢板治疗胫骨近端平台骨折的临床疗效。
我们对2018年6月至2020年5月在作者所在机构前瞻性收治的53例根据Schatzker分类法治疗的胫骨近端平台骨折患者进行了研究，随访期为6个月，采用胫骨近端关节周围钢板治疗。
在我们的研究中，平均膝关节评分为89.30（范围为79至93），膝关节功能评分为97.92（范围为75至100）。根据膝关节协会评分，51例（96.23%）患者显示出优异的结果，2例（3.77%）患者显示出良好的结果，这表明采用钢板内固定治疗胫骨近端平台骨折可提供更好的效果。53例患者中，9例有术后并发症。平均在14周时可见影像学骨愈合。
胫骨近端平台骨折使用锁定加压钢板可起到良好的生物学固定作用，即使在复杂骨折情况下也能提供稳定的固定、关节复位和肢体对线。采用钢板固定胫骨近端平台骨折可使膝关节协会评分优异或良好，功能和影像学结果令人满意。
