Limited Incision And Bone Grafting For The Treatment Of Collapsed Tibial Plateau Fractures

Objective: It observed clinical efficacy and verified security consideration through implement the limited open pages graft and bone plate internal fixation in the treatment of the collapse of the tibial plateau fracture(Schatzker type II and III). Methods: From January 2014 to April 2015, Chengdu hospital traumatology department of hip and knee joint group, had received 30 persons suffering from Schatzker types II and III tibial plateau fractures, who complied with criteria and met requirement of follow-up observation, and taken the method of treatment of open pages graft bone plate internal fixation. In 30 cases, there were 14 males and 16females; the age was from 27 to 65 years old, with a median of 50.1 years; there were17 cases on left knee, 13 cases on right knee; there were 18 cases of Schatzker type II,12 cases of type III, 1 case of prior to the merger of the cruciate ligament injury, 10 cases of meniscus injury, and 6 cases of fibular fracture. All of this groups were fresh closed single knee injury. Through keeping records of surgery time and amount of bleeding, observing patient wound and fracture healing, taking the image evaluation in follow-up visit in 6 months after surgery and the knee score evaluation criteria of United States special surgical hospital(hospital for special surgery, HSS), it was assessment to patient knee function. Meanwhile, observing occurrence of patient postoperative compliance and assessing comprehensive efficacy, grading and statistical analysis, it was objectively assessment the treatment effect, which limited open pages bone plate internal fixation on the recovery of after collapse of the tibial plateau fractures of knee joint in patients with graft. Results: In this group, the surgery time was 85.10-105.80 min, with the median 95.45 min; the amount of bleeding was90.02-130.91 ml, with the median 110.45 ml. The time of follow-up visit was 8-18 months, with the median 11.7 months. Surgical incision were healed in Crade A, and the healing time was 12-24 weeks, with the median 16 weeks, without internal fixation fracture and other postoperative complications. In 6 months postoperation,there were not anatomical line force of change and the joint surface of the second collapse in X-ray imaging learning evaluation. In postoperative active, the knee flexion was 98-142 degrees, with the median 121.3 degrees; the knee extensor was0-5 degrees, with the median 2.3 degrees. According to the HSS knee function score in the follow-up visit in 6 months postoperation, the results were excellent in 20 cases,good in 7 cases and fair in 3 cases. According to the results of the Standard of Chinese Medicine Orthopedics Disease Diagnosis and Treatment, the curative effect wasevaluated: 26 cases were cured, 4 cases were improved, 0 cases were ineffective.Conclusion: limited open pages graft in the bone plate internal fixation for the treatment of collapse of the tibial plateau fracture(Schatzker type II and III)satisfactory curative effect, small trauma, fewer complications, can achieve full bone graft is effective, good reduction of articular surface.