Curative effect of anterior combined with posterior approach in treatment of complex tibial plateau fractures involving the posterior column
LI Guo-wen
LIU Zhi-bin
LI Yi
DING Zhi-yong
HUANG Yu-liang
Abstract：Objective To explore the curative effect of anterior combined with posterior approach in treatment of complex tibial plateau fractures involving the posterior column.Methods Twenty-two patients with complex tibial plateau fractures involving the posterior column treated in trauma department of orthopedics in Huizhou Central People`s Hospital from Jan.2012 to Jan.2014 were selected.There were 14 males and 8 females with age ranging from 20 to 70 years(average,49.7 years).Causes of injury included traffic accident in 15 cases and falling in 7 cases.There was anterolateral tibial plateau fracture in 6 cases,medial tibial plateau fracture in 11 cases,and extensive fracture of tibial plateau in 5 cases.The time from injury to operation was 3 to 14 days,averaging (6.5±2.2) days.They were all given steel plate internal fixation with inverted "L" incision approach from medial or anteromedial posterior commissure.The clinical data was analyzed retrospectively,including operative time,intraoperative blood loss,length of hospital stay,intraoperative complications,fracture healing time and American special surgical hospital (HSS) score in 12 months after surgery.Results All patients were operated successfully.The mean operation time was (173.4±40.3)min;the mean blood loss was (187.5±53.1)mL;the postoperative hospital stay was (16.3±4.6)d;and the mean fracture healing time was (31.2±7.5)weeks.There was no severe complication after surgery.The mean HSS score was 84.6±17.3 and the excellent and good rate was 81.8%(18/22) at 12 months after operation.There was no significant difference in range of motion between bilateral knee joints(P>0.05).Conclusion As for complex tibial plateau fractures involving the posterior column,steel plate internal fixation with inverted "L" incision approach from medial or anteromedial posterior commissure has advantages of less tissue injury and full exposure,which is helpful for the direct reduction and fixation of the knee joint with minimal influence.
Keywords：tibial plateau fractureposterior column fracturecombined incisioninternal fixation
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 439-442 )