The Clinical Effect Of Surgical Treatment Of Complex Tibial Plateau Fractures Involving The Posterior Column

Objective To investigate the clinical effect of surgical treatment of complex tibial plateau fractures involving the posterior column.Methods From December 2012 to April 2015,24 patients of complex tibial plateau fractures involving the posterior column were treated in the second affiliated hospital of Nanjing Medical University.This study involved 16 males and 8 femoral,with an average age of 41.6±2.3 years(range,24 to 57).According to Three-Column Classification,there were 2 one-column fractures,14 two-column fractures,8 three-column fractures,of which one-column fractures were treated with posteromedial reversed L-shaped approach,two-column fractures with posteromedial and anterolateral approach,three-column fractures with posteromedial reversed L-shaped and anterolateral approaches.We analysed TPA and PA on radiographies in follow-up,HSS scores was used to evaluate the knee function of post-operation.Results All patients were obtained follow-up data,with an average of 18.5±3.1 months and average union time of 16.3±1.8 weeks.The averger ROM of the affected knee joints was 117.5°±8.6°.There were no significant differences in either the TPA or PA between immediately and one year after operation.The result of HSS scores was excellent in 14 patients,good in 7,fair in 3,with a good to excellent result rate of 87.5%.Conclusion Three-Column Classification plays a instructive role in the treatment of complex tibial plateau fractures involving the posterior column,which can result in anatomic reduction,satisfactory fixation and early functional rehabilitation.