Combining plates and nails in the treatment of ipsilateral unicondylar tibial plateau and shaft fractures
10.3760/cma.j.issn.0253-2352.2012.08.006
- VernacularTitle:钢板结合髓内钉治疗胫骨单髁伴同侧胫骨干中、远段骨折
- Author:
Lei HUANG
;
Yanzhao ZHU
;
Feng ZHANG
;
Penghan YE
;
Xianfeng HE
;
Yongping RUAN
;
Rongming XU
- Publication Type:Journal Article
- Keywords:
Tibial fractures;
Fracture fixation,internal;
Fracture fixation,intramedullary
- From:
Chinese Journal of Orthopaedics
2012;32(8):739-744
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the feasibility and effect of combining intramedullary nails and plates in the treatment of ipsilateral unicondylar tibial plateau fractures with non.contiguous tibial shaft fractures.Methods From May 2003 to November 2005,21 patients with ipsilateral unicondylar tibial plateau fracture and non-contiguous tibial shaft fracture were treated with combining intramedullary nails and plates,including 15 males and 6 females,with the mean age of 34 years (range,20-55 years).The tibial plateau fractures were classified according to Schatzker et al.; 4 cases were type Ⅰ,11 cases type Ⅱ,6 cases type Ⅲ and 1 case type Ⅵ.Middle third tibial shaft fractures were in 13 patients,and distal third tibial shaft fractures were in 8 patients.Once the reduction was obtained,we first fixed tibial plateau with plate and then tibial shaft with medullary nail in 19 cases; in 2 cases,we first fixed the tibial shaft with medullary nail and then tibial plateau with plate.Results 1All patients were followed up for 0.9 to 4 years (average,2.2 years).Bone union was obtained in all patients.The tibial plateau fractures united after an average of 12 weeks,and the tibial shaft fractures united after an average of 29 weeks.Delayed union of the tibial shaft fracture occurred in 3 patients,and the fracture healed finally by removing the proximal locking.Tibial plateau malunion occurred in one patient due to malreduction.According to HSS scores,excellent result was obtained in 17 patients (80.95％),good in 3 patients (14.29％),fair in 1 patient (4.76％).Conclusion With careful attention to some techniques,ipsilateral unicondylar tibial plateau fractures with non-contiguous tibial shaft fractures can be treated successfully by combining medullary nail and plate.
