Three-column classification in the treatment of complex tibial plateau fractures
ZHI Chun-sheng
WU Bo
JIN Ye-hua
LIU Jun
XING Ben
Abstract：Objective To investigate and evaluate the effects of three-column classification in the treatment of complex tibial plateau fractures. Methods From May 2010 to May 2014, three -column classification was used in the determination of the fixation method and surgical approach in 82 cases of closed complex tibial plateau fractures. The group included 58 males and 24 females aged from 27 to 58 years old ( average: 35.6 years ). According to the three-column classification, there were 48 two-column fractures and 34 three-column fractures. The average period from the injury to the surgery was 9.6 days ( range: 5 - 16 days ). Postoperative clinical and radiographical examinations were taken. Knee functions were evaluated by hospital for special surgery ( HSS ) 12 months postoperatively. Results All patients obtained follow-up and the average follow-up was 16.4 months ( range: 12 - 30 months ). The average time of the surgery, full weight bearing and fracture union were 110 min ( range: 90 - 160 min ), 13.2 weeks ( range: 12 -16 weeks ) and 13.2 weeks ( range: 10 - 14 weeks ) respectively. No statistical differences were found in either the tibial plateau angle ( TPA ) or posterior slope angle ( PA ) when comparing the measurement results immediately after the surgery and 12 months postoperatively on radiographs. The mean HSS 12 months postoperatively was 83.6 points ( range: 66 - 94 points ) with the excellent and good rate 86.6%. The average range of motion ( ROM ) of the affected knee joints was 1.5° to 115° 12 months postoperatively. Delayed union occurred in 6 cases. There were 4 cases of superficial infection and 7 of partial incision necrosis, and all were healed with wound management. Deep infection in 4 cases was healed after the debridement and implant removal. Numbness in the posterior-inferior part of the calf was recorded in 2 cases. Deep vein thrombosis of the lower extremity was found in 21 cases, and 12 of them were placed inferior vena cava filter. Conclusions Three-column classification is effective and instructive in the treatment of complex tibial plateau fractures, especially when the fracture involves the posterior column. It is safe and effective with direct reduction, firm fixation and satisfactory recovery of the knee functions.
Keywords：TibiaFracturesboneIntra-articular fracturesFracture fixationinternal
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 473-477 )