Clinical observation of internal ifxation of posterolateral tibial plateau fractures through ifbular head osteotomy

ZHANG Bin; HUANG Qi; LI Lang; XIE Lin; LI Qiang; GAO Feng

doi:10.3969/j.issn.2095-252X.2015.06.010

Abstract：Objective To evaluate short-term outcomes of internal ifxation of posterolateral tibial plateau fractures through ifbular head osteotomy.Methods From August 2011 to January 2014, 14 patients with posterolateral tibial plateau fractures were treated through fibula osteotomy. There were 6 males and 8 females, aging from 28 to 72 years. The average age was 34.2 years old. According to the Schatzker classiifcation, 4 cases were of type I, 8 cases type II and 2 cases type III. All patients were of fresh closed fractures. Ten cases were combined with ipsilateral fibular head fracture. No vascular or nerve injury exited. Operation time, blood loss, postoperative complications were analyzed in all patients. Rasmussen score was applied to evaluate the fracture reduction and the range of motion of the knee. Hospital for Special Surgery ( HSS ) knee score was applied to assess the functions of involved knee. Results All patients were followed up. The average follow-up period was 21.4 months ( range: 4 to 40 months ). The mean operative time was 75 minutes ( range: 60-95 minutes ). The average blood loss was 100ml ( range: 60- 300 ml ). Anatomical reduction was achieved in all patients. The average Rasmussen score was 16.5 points ( range: 14-18 points ). There was neither neurovascular injury nor wound infection. All wounds were of I / A healing. During the follow-up, no reduction loss, nonunion or delayed union of fractures, or complications occurred. The average range of motion of the knee was 126.4° ( extension -5°-0, lfexion 80-135° ). The average HSS knee score was 90 points ( range:65-98 points ).Conclusions Internal ifxation of posterolateral tibial plateau fractures through ifbular head osteotomy can obtain good clinical outcomes with sufifcient exposure, ifne reduction and ifxation, and satisfactory fracture healing and function recovery.