Tibial plateau fractures osteosynthesis—a case series of 88 patients evaluating surgical approaches, results and complications

Detalhes bibliográficos
Autor(a) principal: Mónico, José Lito dos Santos
Data de Publicação: 2021
Outros Autores: Andrade, Renato, Matos, Pedro, Mónico, Lisete, Mariano, João Cura, Espregueira-Mendes, João, Fonseca, Fernando
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10316/100962
https://doi.org/10.21037/aoj-20-95
Resumo: Background: Tibial plateau fractures can be treated using different surgical approaches and different fixation methods. With multiple surgical options available, optimal treatment is still controversial. With variable results, surgical osteosynthesis remains challenging, being the choice of appropriate fixation method fundamental for a favourable clinical outcome. Our goal is to analyse the surgical outcomes of patients with tibial plateau fractures submitted to osteosynthesis using different surgical approaches. Methods: There were 88 tibial plateau osteosynthesis performed over a 5-year period. Among others, surgical approach, fixation methods and surgical outcomes were analysed. Results: The overall complication rate was 11.4%, with deep infection being the most common. Single surgical approach had a lower complication rate (2.25%) than double approaches (33.3%). The type of plate used was not correlated with postoperative complications. Unsatisfactory surgical reductions were obtained in 15.9%. There was negative significant association between the baseline Schatzker classification and the reduction. The type of plate usage was not associated with unsatisfactory reductions, but locking compression plates (LCPs) were associated with more anatomical reductions comparing to compression plates. Bone graft was used in 51% of patients and there was no correlation with fracture reduction, fracture consolidation or postsurgical complications. Conclusions: The severity of the tibial plateau fracture is associated with the surgical outcomes. If an acceptable reduction can be obtained, single surgical approach and single plate osteosynthesis is a safer option than double surgical approaches with double plating.
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spelling Tibial plateau fractures osteosynthesis—a case series of 88 patients evaluating surgical approaches, results and complicationsTibial plateau fracturessingle and double surgical approachesfracture plate fixationfracture fixation outcomesBackground: Tibial plateau fractures can be treated using different surgical approaches and different fixation methods. With multiple surgical options available, optimal treatment is still controversial. With variable results, surgical osteosynthesis remains challenging, being the choice of appropriate fixation method fundamental for a favourable clinical outcome. Our goal is to analyse the surgical outcomes of patients with tibial plateau fractures submitted to osteosynthesis using different surgical approaches. Methods: There were 88 tibial plateau osteosynthesis performed over a 5-year period. Among others, surgical approach, fixation methods and surgical outcomes were analysed. Results: The overall complication rate was 11.4%, with deep infection being the most common. Single surgical approach had a lower complication rate (2.25%) than double approaches (33.3%). The type of plate used was not correlated with postoperative complications. Unsatisfactory surgical reductions were obtained in 15.9%. There was negative significant association between the baseline Schatzker classification and the reduction. The type of plate usage was not associated with unsatisfactory reductions, but locking compression plates (LCPs) were associated with more anatomical reductions comparing to compression plates. Bone graft was used in 51% of patients and there was no correlation with fracture reduction, fracture consolidation or postsurgical complications. Conclusions: The severity of the tibial plateau fracture is associated with the surgical outcomes. If an acceptable reduction can be obtained, single surgical approach and single plate osteosynthesis is a safer option than double surgical approaches with double plating.2021info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://hdl.handle.net/10316/100962http://hdl.handle.net/10316/100962https://doi.org/10.21037/aoj-20-95eng24156809Mónico, José Lito dos SantosAndrade, RenatoMatos, PedroMónico, LiseteMariano, João CuraEspregueira-Mendes, JoãoFonseca, Fernandoinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-07-23T20:40:11Zoai:estudogeral.uc.pt:10316/100962Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T21:18:14.314676Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Tibial plateau fractures osteosynthesis—a case series of 88 patients evaluating surgical approaches, results and complications
title Tibial plateau fractures osteosynthesis—a case series of 88 patients evaluating surgical approaches, results and complications
spellingShingle Tibial plateau fractures osteosynthesis—a case series of 88 patients evaluating surgical approaches, results and complications
Mónico, José Lito dos Santos
Tibial plateau fractures
single and double surgical approaches
fracture plate fixation
fracture fixation outcomes
title_short Tibial plateau fractures osteosynthesis—a case series of 88 patients evaluating surgical approaches, results and complications
title_full Tibial plateau fractures osteosynthesis—a case series of 88 patients evaluating surgical approaches, results and complications
title_fullStr Tibial plateau fractures osteosynthesis—a case series of 88 patients evaluating surgical approaches, results and complications
title_full_unstemmed Tibial plateau fractures osteosynthesis—a case series of 88 patients evaluating surgical approaches, results and complications
title_sort Tibial plateau fractures osteosynthesis—a case series of 88 patients evaluating surgical approaches, results and complications
author Mónico, José Lito dos Santos
author_facet Mónico, José Lito dos Santos
Andrade, Renato
Matos, Pedro
Mónico, Lisete
Mariano, João Cura
Espregueira-Mendes, João
Fonseca, Fernando
author_role author
author2 Andrade, Renato
Matos, Pedro
Mónico, Lisete
Mariano, João Cura
Espregueira-Mendes, João
Fonseca, Fernando
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Mónico, José Lito dos Santos
Andrade, Renato
Matos, Pedro
Mónico, Lisete
Mariano, João Cura
Espregueira-Mendes, João
Fonseca, Fernando
dc.subject.por.fl_str_mv Tibial plateau fractures
single and double surgical approaches
fracture plate fixation
fracture fixation outcomes
topic Tibial plateau fractures
single and double surgical approaches
fracture plate fixation
fracture fixation outcomes
description Background: Tibial plateau fractures can be treated using different surgical approaches and different fixation methods. With multiple surgical options available, optimal treatment is still controversial. With variable results, surgical osteosynthesis remains challenging, being the choice of appropriate fixation method fundamental for a favourable clinical outcome. Our goal is to analyse the surgical outcomes of patients with tibial plateau fractures submitted to osteosynthesis using different surgical approaches. Methods: There were 88 tibial plateau osteosynthesis performed over a 5-year period. Among others, surgical approach, fixation methods and surgical outcomes were analysed. Results: The overall complication rate was 11.4%, with deep infection being the most common. Single surgical approach had a lower complication rate (2.25%) than double approaches (33.3%). The type of plate used was not correlated with postoperative complications. Unsatisfactory surgical reductions were obtained in 15.9%. There was negative significant association between the baseline Schatzker classification and the reduction. The type of plate usage was not associated with unsatisfactory reductions, but locking compression plates (LCPs) were associated with more anatomical reductions comparing to compression plates. Bone graft was used in 51% of patients and there was no correlation with fracture reduction, fracture consolidation or postsurgical complications. Conclusions: The severity of the tibial plateau fracture is associated with the surgical outcomes. If an acceptable reduction can be obtained, single surgical approach and single plate osteosynthesis is a safer option than double surgical approaches with double plating.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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dc.identifier.uri.fl_str_mv http://hdl.handle.net/10316/100962
http://hdl.handle.net/10316/100962
https://doi.org/10.21037/aoj-20-95
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https://doi.org/10.21037/aoj-20-95
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