The short term and long term effects of the complex tibial plateau fractures treated with three-column fixation

LIANG Yu; HE Rong-fu; LI Lin-tao; XIANG Sheng-jian; WANG Chuan; ZHONG Feng-lin

doi:10.3969/j.issn.1009-4237.2018.02.013

Abstract：Objective To explore the short term and long term effectiveness of complex tibial plateau frac-tures treated with three-column fixation.Methods From Jan.2011 to Jan.2015,24 closed complex tibial plateau fractures were treated using the three-column fixation concept in orthopedic department,Panzhihua Central Hospital of Sichuan province.There were 15 males and 9 females,and their age was from 20 to 58 years with an average of 42.4 years.According to Schatzker classification of the tibial plateau fractures,there were 8 cases of type V and 16 cases of type VI.According to three-column classification,all the cases were three-column fractures.The mean in-terval time from injury to operation was 8.5d.Radiologic results were evaluated by mechanical indexes immediately after operation,1-month,3-month,6-month,12-month 24-month postoperatively.The short term and long term effec-tiveness were estimated by hospital for special surgery knee score(HSS)at 1-month,3-month,6-month,12-month and 24-month postoperatively.Results No significant difference was found in mechanical indexes among immedi-ately after surgery,1-month,3-month,6-month,12-month and 24-month post-operative measurements.However, there were significant differences concerning pain,function,range of motion,muscle strength and joint stability,ex-cept for flexion deformity.The therapeutic effects were worst at the first month postoperatively,with the increase of rehabilitation training,the best therapeutic effects were achieved at twenty-fourth months postoperatively.Conclu-sion The short-term therapeutic effects are not ideal for patients associated with high energy tibial plateau frac -tures.To make these patients achieve satisfactory long-term effect,it is very important that medical personnel pro-vide detailed rehabilitation training plan and close telephone follow-up.