Comparative Efficacy With Locking Plate And The Normal Plate For Treatment Of Elderly Tibial Plateau Fractures In Schatzker Ⅱ, Ⅲ Type

Objective: Elderly osteoporosis, tibial plateau fractures can occur mild violence, prone to loosening of the implant, extrusion, leading to fixation failure, and the underlying diseases associated with more intractable. With the development of diagnostic techniques in recent years, and plate fixation of fractures better understanding of biomechanics, the application of locking plates has greatly increased the postoperative tibial plateau fracture in excellent yield. Special Summary tibial plateau fracture characteristics, classification and treatment, by exploring the application of locking plate for tibial plateau SchatzkerⅡ,Ⅲfracture of surgical methods, and non-lock support plate in the treatment efficacy compared to assess the locking plate in the treatment of tibial Plateau fractures clinical value, summed up the treatment of tibial plateau fracture elderly clinical experience.Methods: Retrospective collection and analysis of the Second Affiliated Hospital of Dalian Medical University, Orthopaedic Surgery, March 2006 to 2010, a period in elderly surgical treatment of tibial plateau SchatzkerⅡ,Ⅲ76 patients with fractures. According to the locking plate fixation were divided into group (44 cases) and non-locking plate group (32 cases), and select the appropriate type according to surgical approach and surgical techniques, perioperative positive control with underlying diseases, postoperative Early exercise to get the average 12-month follow-up. Statistics include standard knee evaluation Rasmussen,then a high loss rate after platform.Results: All patients were followed, locking plate group fractures healed in 16 weeks, non-locking plate group, 1 case out because of the internal fixation plate is loose, and the remaining patients the fractures were healed in 16 weeks. Rasmussen assessed using clinical scoring criteria, the result is -6 months: locking plate were excellent in 16 cases, good in 17 cases, 8 cases and poor in 3 cases, 75% good; ordinary steel were excellent in 8 cases, good in 8 cases, In 12 cases and poor in 4 cases, good rate of 50%. 12 months: locking plate were excellent in 22 cases, good in 18 cases, 3 cases and poor in 1 cases, good in 86.96%; ordinary steel were excellent in 12 cases, good in 10 cases, 8cases and poor in 2 cases, good rate of 68.75%.the difference was statistically significant (p <0.05).Platform height locking plate group was lost again the incidence (15.9%) than ordinary steel group (37.5%), the difference was statistically significant (p <0.05). Platform height locking plate group was lost again the incidence (15.9%) than ordinary steel group (37.5%), the difference was statistically significant (p <0.05).Conclusion: The elderly osteoporosis, tibial plateau fractures can occur mild violence, prone to cause platform collapse, bone defects, internal fixation is not solid,easy to be lost after a high platform. Compared with ordinary steel locking plate holding force, shear and strong, and osteoporosis, which anchors the anchor force and good resistance to pull-out strength, fixed firmly in favor of early functional exercise of knee joint, get a good joint function Reduce the incidence of long-term complications of bed rest and to avoid or mitigate further loss of height after platform.