Revision of Schatzker type Ⅵ tibial plateau fracture failure focus on the recovery of lower limb alignment
10.3760/cma.j.issn.0529-5815.2018.03.005
- VernacularTitle: Schatzker Ⅵ型胫骨平台骨折术后下肢力线异常的翻修手术效果
- Author:
Ruijun CONG
1
;
Junfeng LIU
;
Yue JIANG
;
Duolikun DILIXIATI
;
Xiaodong HOU
;
Longpo ZHENG
Author Information
1. Department of Orthopedics, Shanghai 10th Hospital(10th Hospital Affiliated to Tongji University), Shanghai 200072, China
- Publication Type:Journal Article
- Keywords:
Tibial fractures;
Fracture Fixation;
Schatzker type Ⅵ;
Lower limb alignment;
Revision surgery
- From:
Chinese Journal of Surgery
2018;56(3):189-195
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the influence of the lower extremity abnormal alignment and the joint surface, and to explore the surgical skills.
Methods:Twenty-two cases of tibial plateau Schatzker Ⅵ fracture internal fixation failure revision from January 2012 to January 2017 in Department of Orthopedics, Shanghai 10th Hospital.One year follow-up after initial surgery to make sure of failure.Three-dimensional CT scan, radiography, infection index, gait analysis, knee joint ROM, femur tibia angle, tibial plateau tibial shaft angle and posterior slope if tibial plateau were observed. The medial approach and bi-planer osteotoma were used.Autogenous iliac bone graft, postoperative fast recovery channel were used.Follow-up point included preoperative and postoperative 7 days, 6 weeks, 3 months, and 6 months.Obvervational index included double lower limbs radiography, knee society score(KSS), complications such as infection, skin necrosis, joint main passive activity, double lower limbs alignment the last follow-up SF-36 scale.Rate was compared by χ2 test, measurement data using paired sample t test.Correlation was analyzed by Pearson correlation regression testing.
Results:Twenty-two patients received follow-up.KSS, more than 21 cases were benign, with good gait.One case was poor, with claudication gait.Not skin necrosis, no deep infection cases, 1 case get blisters 2 days postoperatively, and disappear after 5 days with detumescence and cold therapy.Whether restoring force line affect the KSS significantly(χ2=22.000, P=0.000). Knee joint ROM, SF-36 score, KSS and lower limb alignment were improved significantly. In different individual the articular surface and anatomical angle recovered greatly but the posterior slope angle was quite difference which has no correlation with KSS and SF-36 scale(P>0.01).
Conclusions:Revision of Schatzker type Ⅵ tibial plateau fracture failure should focus on the recovery of lower limb alignment.moderate overcorrect bone cutting and joint surface height can bring benefits to the postoperative knee function.Revision surgery patients have greater psychological pressure, more early psychological intervention is necessary.
