Lateral locking combined with medial support plate versus double support plate for repair of tibial plateau fractures

Ma Yun-hong

doi:10.3969/j.issn.2095-4344.2014.35.008

Abstract：BACKGROUND:Unilateral support plate in the treatment of complex tibial plateau fractures easily formed eccentrical y brace, and easily led to angular deformity. The outer support plate alone is prone to knee varus deformity. OBJECTIVE:To compare the clinical and imaging effects with the outer locking plate combined with inner support plate fixation and double support plate using dual lateral incision in the repair of complex tibial plateau fracture. METHODS:We retrospectively analyzed the clinical data of 86 patients with complex tibial plateau fractures from March 2009 to November 2013. According to the different fixations, patients were divided into two groups. Outer locking plate combined with inner support plate group:lateral locking plate fixation for complex and comminuted fractures, and support plate was used in the inner side. Double support plate group used internal and external support plates. Patients were fol owed up for 2 years after the surgery. Clinical and imaging effects of two different fixations were compared. RESULTS AND CONCLUSION:Wounds were stage I healing in al the fol ow-up patients. Bone healing was conducted. No significant difference in operation time, time of tourniquet and intraoperative blood loss was detectable between both groups (P>0.05). Postoperative fol ow-up demonstrated that ful load time was significantly earlier in the outer locking plate combined with inner support plate group than in the double support plate group (P<0.05). No significant difference in fracture healing time, hospital for special surgery score, range of knee motion and postoperative tibial plateau angle, posterior slope angle and postoperative 1 year tibial plateau angle, posterior slope angle was detected between the two groups (P>0.05). These data confirmed that dual lateral incision double plate fixation in the repair of tibial plateau fractures had wel clinical and imaging features. Compared with the double support plates, outer locking plate combined with inner support plate has superiority in ful load time.