Surgical Treatment Of Schatzker â…£ Tibial Plateau Fracture

Objective: To summarize the current Schatzkerâ…£tibial plateau fracture of the various treatment methods, analysis of its efficacy, and compare our results with domestic and abroad reports. Eventrually compare the clinical outcome of locking compression plate and anatomic butress plate in fixation of tibial Schatzkerâ…£plateau fracture.Methods: 42 patients with Schatzkerâ…£tibial plateau fracture were treated with open reduction and internal fixation between January 2003 ~ January 2009 at our hospital. Complete follow-up data of 26 patients were obtained. The patients average age were 36.3 years. According to the different internal fixation, these patients were divided into locking compression plate fixation group(16 cases) and anatomic butress plate group(10 cases). Follow-up period was 1 to 7 years with average follow-up time 2.2 years. Clinical Evaluation was through application of HSS knee score, radiographic evaluation of tibial plateau fractures and Rasmussen anatomical scoring.Statistical software SPSS17.0 were used to analyze the patients HSS knee score, Rasmussen excellent rate of imaging. compare the clinical outcome of locking compression plate and anatomic butress plate in fixation of tibial Schatzkerâ…£plateau fracture.Results: According to the reference standard of HSS knee score, the Average in LCP group was 79.9 and there were 7 cases with excellent results, good in 5 cases, fair in 4 cases, and the excellent rate was 75%. 2 cases with excellent results in anatomical support plate group, good in 3 cases, fair in 4 cases and poor in 1 case, Average was 71.8and excellent rate was 50%; Imaging evaluation of tibial plateau fractures was through Rasmussen scoring anatomy, LCP group were excellent in 7 cases, good in 6 cases, fair in 3 cases, good rate was 81.2%. Butress plates group were excellent in 2 cases, good in 3 cases, fair in 4cases and poor in 1 case , the good rate was 50%.The above data was analyzed by four tables from Fisher test and the results showed two kinds of internal fixation treatment of Schatzkerâ…£tibial plateau fracture fine had significant difference (P < 0.05), meanwhile locking compression plate group did better than the anatomical support plate group in wound infection, a high degree of loss, knee varus deformity, traumatic joint the incidence of postoperative complications so far.Conclusion:(1)LCP afford a stable and durable fixation to avoid the replacement and change of the knee mechanics. Combining bone transplantation, it achieve reliable effect.(2)Anatomical reduction, positively remedy injury of ligament and meniscus probably prevent complications of the tibial plateau fractures.