El- Gyoshi, A., Zayed, F., Massoud, M. (2018). Percutaneous Fixation of Split Fracture Tibial Plateau. The Egyptian Journal of Hospital Medicine, 73(9), 7531-7541. doi: 10.21608/ejhm.2018.19554
Ali Mohammed Mahmoud El- Gyoshi; Faisal Hassan Youssef Zayed; Mahmoud Hamouda Taha Massoud. "Percutaneous Fixation of Split Fracture Tibial Plateau". The Egyptian Journal of Hospital Medicine, 73, 9, 2018, 7531-7541. doi: 10.21608/ejhm.2018.19554
El- Gyoshi, A., Zayed, F., Massoud, M. (2018). 'Percutaneous Fixation of Split Fracture Tibial Plateau', The Egyptian Journal of Hospital Medicine, 73(9), pp. 7531-7541. doi: 10.21608/ejhm.2018.19554
El- Gyoshi, A., Zayed, F., Massoud, M. Percutaneous Fixation of Split Fracture Tibial Plateau. The Egyptian Journal of Hospital Medicine, 2018; 73(9): 7531-7541. doi: 10.21608/ejhm.2018.19554
Percutaneous Fixation of Split Fracture Tibial Plateau
Department of Orthopedic Surgery, Faculty of Medicine, Al Azhar University
Abstract
Background: tibial plateau fractures represented only 1% of all fractures. If not appropriately treated, the consequences may be severe and have a great social impact. The management of the fracture depends on several factors such as fracture configuration, concomitant soft tissue injury, the patient's age, activity level and bone quality. Tibial plateau fractures may be divided into low energy or high energy fractures. Low energy fractures are common in older patients due to osteoporotic bone and are typically depressed fractures. High energy fractures are commonly the result of motor vehicle accidents, falls or sportsrelated injuries. Split tibial plateau fractures may be treated by closed reduction and percutaneous fixation using cancellous screws and washers, with very good results as recommended by many authors.Objective: the aim of this study was to evaluate the results of closed reduction under fluoroscopic control and percutaneous fixation with cancellous screws 6.5 mm and washers of split type of tibial plateau fractures. Methodology: twenty patients were included in this study; they were admitted to the Department of Orthopedic Surgery, Sayed Galal Hospital and luxor International Hospital, from October 2016 to April 2018. On admission all patients were assessed by history taking, clinical examination and radiological assessment. The mean age of patients in this study was 37.15 ± 11.4 years. Age was ranged from 20 to 55 years. There were 13 males (65 %) and 7 females (35 %). 11 patients (55 %) had right side tibial plateau fracture, while only 9 patients had left side tibial plateau fractures. Results: 12 (60 %) patients had traffic accidents as a mechanism of injury, 4 (20 %) were falling from height, 4 (20 %) had direct trauma. Associated fractures of the head of fibulae was present in two patients (10 %), other associated fractures were Colles' fracture (5%), femoral shaft fracture (5 %) and fracture tibia (5 %).The time till operation varied from two days to five days, but the majority of the cases were done within the first two to three days after admission. The mean duration of follow up was 6.5 ± 2.86 months, ranging from six to eight months. After follow up period the result were assessed according to Rasmussen's grading system, eighteen patients (90%) had excellent results, and two patients (10 %) had good results. Conclusion: tibial plateau fractures represented only 1% of all fractures. If not appropriately treated, the consequences may be severe and have a great social impact. Early mobilization is an important factor in treatment of intra articular fracture, as immobilization result in death of chondrocyte. Percutaneous reduction and fixation technique is a simple procedure if facilitates, equipment and experience are available.
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