Tibial Plateau Fracture An Analysis of the Results of Treatment in 37 Patients

Moon, Myung Sang; Woo, Young Kyun; Sim, Seon Sik

Abstract

Tibial plateau fractures are a common injury which often produce major disability. The extent of actural damage is always greater than that suggested by X-ray, a situation which, if not appreciated, can easily lead to a complacent surgical attitude. Although recent studies suggest that early knee motion and perhaps better surgical technique have improved clinical end-results, still recent series show unaccepatble results in 20-40 percent of cases. The authors analyzed the 37 cases of the tibial plateau fractures treated at the Department of Orthopaedics, Catholic University Medical College, Kang-Nam St. Mary's Hospital and following results were obtained. 1. The highest incidence was in the 5th decade and the next was 4th, and most frequent cases of trauma was pedestrian car accident(83%). 2. The most common fracture type was type VI by Schatzker classification and next was type II. 3. Among 37 cases, 27 were treated by open reduction and internal fixation and 14 out of those 27 cases meeded bone graft for the elevation of the tibial articular surface. 4. According to Blokker's criteria(1984), 32(86.6%) out of 37 cases had satisfactory result. Among 5 cases of unsatisfactory results 3 cases developed varus tilting of the tibial plateau more than 10 during the early stage (6-12 weeks post operation) of follow-up and those 3 were Schatzker's type VI fracture. 5. It is thought that open anatomical reduction of articular surface bone graft, internal fixation and early joint motion are the best way for the treatment of depressed or displaced fracture. 6. It is found tha Schatzker's type VI fracture has a tendency to develop varus tilting through the proximal tibial fracture before it unites completely.