Staged Treatment of Bicondylar Tibial Plateau Fracture (Schatzker Type V or VI) Using Temporary External Fixator: Correlation between Clinical and Radiological Outcomes
- Author:
Seung Min RYU
1
;
Han Seok YANG
;
Oog Jin SHON
Author Information
- Publication Type:Original Article
- Keywords: Tibia; Plateau; Bicondylar; Fracture; External fixator
- MeSH: External Fixators; Extremities; Fluoroscopy; Humans; Knee; Ontario; Osteoarthritis; Range of Motion, Articular; Surgeons; Tibia
- From:The Journal of Korean Knee Society 2018;30(3):261-268
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: This study is to investigate clinical and radiological results of staged treatment using a temporary external fixator in bicondylar tibial plateau fractures (TPFs) and to evaluate correlation between prognostic factors and postoperative clinical outcomes. MATERIALS AND METHODS: Twenty-four bicondylar TPF patients were selected. All patients were operated by a temporary external fixator first and then open reduction and internal fixation with dual plating. Clinical and radiological outcomes were evaluated. RESULTS: The mean American Knee Society score (AKSS) was 85.3. The mean Western Ontario and McMaster Universities Osteoarthritis index was 11.2. The mean range of motion (ROM) was 123.4°. The mean medial tibial plateau angle (mTPA) was 88.3°, and the mean proximal posterior tibial angle (PPTA) was 8.4°. Compared with the uninjured limb, the mean difference of mTPA was 1.5° and that of PPTA was 4.0°. The difference of PPTA and the AKSS demonstrated negative correlation (p=0.007). Patients with normal mTPA showed better ROM than those with abnormal mTPA (p=0.041). CONCLUSIONS: Staged treatment using a temporary external fixator in bicondylar TPFs showed good clinical and radiological outcomes. Surgeons should evaluate the reduction status intraoperatively by fluoroscopy and also refer to the uninjured limb radiologically.
