Clinical Study On The Treatment For Tibial Piateau Fractures By Different Approaches

Objective:the goal of this study was to explore the clinical therapeutic effect of different surgical treatment according to the tibial plateau fractures.Hope to provide some references for the design of clinical surgical treatment.Methods:Collecting the clinical data of 62 patiens who underwent tibial plateau fracture from January 2013 to March 2016 in our hospital.There were 33 males and 29 females with the average age of 48.0 years old.There were 23 cases with traffic accident injury,22 cases with falling injury,5 cases with heavy injury and 12 cases others.Fracture according to the Schatzker classification: type Ⅰ 4 cases,Ⅱ type 28 cases,Ⅲ type 2 cases,Ⅳ type 6cases,Ⅴtype 11 cases,Ⅵtype 9 cases,and can not be classified 3 cases.According to the Three-Colunm Classification,there were 2 pure compression fractures,32 one-column fractures,19 two-cdumn fractures and 10 three-column fractures.Different surgical methods were selected according to different tibial plateau fracture types.The postoperative follow-up and clinical evaluation were evaluated,including the postoperative complications,the tibial plateau angle(TPA)and posterior slope angle(PA)on the radiographies between immediate post-operation and 12 months post-operation,the knee movement degree and the Hospital for Special Surgery(HSS)score.Results: A total of 62 patients received an average of 27.3 months(12 to 49 months)followed up and bone healing could be seen in all of them.There was no significant difference between the TPA and PA on the radiographies between immediate post-operation and 12 months post-operation(P> 0.05).The mean follow-up HSS score was 87.9.Conclusion: According to the results of preoperative examination and different types of tibial plateau fractures,designing the surgical plan,including surgical position,approach,inner fixing position,will lead to improvements in outcome.