A Comparative Therapeutic Effect Of Common Anatomical Plate And Locking Plate For The Treatment Of Complex Fractures Of Tibial Plateau

Objective A retrospective study was conducted to investigate the therapeutic effect of common anatomical plate and locking plate for the complex fractures of tibial plateau.Methods From May 2005 to April 2009,30 patients with complex tibial plateau fractures were treated with common anatomical plate and locking plate,comparing the difference of the partial weight-bearing time,the complications of soft tissue,tibial plateau angle(TPA) and posterior slope angle(PA),ROM of the knee joints,knee joint's HSS(The Hospital for Special Surgery) scores.Results 28 cases had completely follow-up records and a mean follow-up of 20.7months(range,1.0 to 50.0 months).1,In the group of common anatomical plate,the mean partial weight-bearing time was 3.9 weeks(range,3.0 to 6.0 weeks),the average ROM of the affected knee joints was 111.1 degrees(range,15.0 to 160.0 degrees),the mean HSS scores of post-operation 6 months was 91.6 points (range,70.0 to 100.0 points).In the group of locking plate,the mean partial weight-bearing time was 3.2weeks(range,1.0 to 6.0 weeks),the average ROM of the affected knee joints was 109.8 degrees(range,15.0 to 160.0 degrees),the mean HSS scores of post-operation 6 months was 81.4 points(range,59.0 to 100.0 points),. There were no significant differerces between the two groups in the above parameters(P＞0.05).2,There were no significant differences between the two groups in change of TPA and PA in the time of post-operation,post-operation 2month,post-operation 6month(P＞0.05).Conclusion1,As to complex fractures of tibial plateau,it must pay close attention to the situation of the soft tissue around the knee joint,make clear the fracture classification and well-designed surgical approach.2,The fractures of articular surface should be anatomic reduction, the metaphyseal fractures should restore the lower extremity force line by indirect reduction.3,The MIPO technology is conducive to less injury,good fracture healing and functional restoration.4,The common anatomical plate and locking plate can provide good fixation for the most complex fractures of tibial plateau.5,It should be ORIF as early as possible and strengthen the rehabilitation training for the floating knee.