Knee Surg Relat Res.  2018 Sep;30(3):261-268. 10.5792/ksrr.17.008.

Staged Treatment of Bicondylar Tibial Plateau Fracture (Schatzker Type V or VI) Using Temporary External Fixator: Correlation between Clinical and Radiological Outcomes

• Ryu SM
• Yang HS
• Shon OJ

• KMID: 2420353
• DOI: http://doi.org/10.5792/ksrr.17.008

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.

Keyword

Tibia; Plateau; Bicondylar; Fracture; External fixator

MeSH Terms

External Fixators*
Extremities
Fluoroscopy
Humans
Knee
Ontario
Osteoarthritis
Range of Motion, Articular
Surgeons
Tibia