Treatment Of Schatzker Ⅰ-Ⅲ Fractures Of Tibial Plateau By Limited Excision With Proximal Tibial Locking Compression Plate

Objective：Treatment of SchatzkerⅠ-Ⅲ fractures of tibial plateau by limitedexcision with proximal tibial locking compression plate, investigate the feasibility andclinical curative effects.Methods：From January2009to January2011,39cases of SchatzkerⅠ-Ⅲfractures of tibial plateau were treated by limited anterolateral incision with proximaltibial locking compression plate in our department, among them27cases were malepatients,12cases were female patients, age from34to63, with an average of45.2.According to the Schatzker classification, typeⅠ9cases，typeⅡ22cases，typeⅢ8cases,all the cases were fresh fracture different from1to7days after injury, none of themhave combined injury. The reduction of the fracture were under direct or indirect vision.The cases with osseous compressed were given bone grafting with the fenestrationunder lateral tibial plateau.35cases were postoperatively followed-up ranged from12to15months, with amean of12.9months. Function of the knee were assessed according to HSS system andradiological examination.Results:35cases were postoperatively followed-up ranged from12to15months,with a mean of12.9months. All of the patients were cured without redisplacement orcomplications related to the internal fixation systems. Only one case showed delayedunion after operation caused by excessively stretched during the operation, the othercases were primary healing, the flexion of the knee12months after operation was from105°to133°, the extension of the knee was from0°to10°, all patients cured withoutwound infection or breakage of internal fixation. Function of the knee were assessedaccording to HSS system and radiological examination, the score of HSS system12 months after operation was90.5（range65-96），the excellent and good rate was94.3%.Conclusion: In the treatment of SchatzkerⅠ-Ⅲ fractures of tibial plateau, limitedexcision with proximal tibial locking compression plate can avoid soft tissue injury,incision complications, and prevent postoperative depression of the tibial plateau andpostoperative change of the knee mechanics, is an effective method to recover thefunction of the affected lower limb.