Comparison of extended anterolateral approach in treatment of simple/complex tibial plateau fracture with posterolateral tibial plateau fracture

Abstract Background Our hospital has recently used the extended anterolateral approach in posterolateral tibial plateau fracture. We compared the clinical effects of this method in Schatzker type II or type V/VI fractures with posterolateral tibial plateau fracture based on our patients. Methods The...

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Main Authors: Liangjun Jiang, Qiang Zheng, Zhijun Pan
Format: Article
Language:English
Published: BMC 2018-11-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13018-018-1007-7
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author Liangjun Jiang
Qiang Zheng
Zhijun Pan
author_facet Liangjun Jiang
Qiang Zheng
Zhijun Pan
author_sort Liangjun Jiang
collection DOAJ
description Abstract Background Our hospital has recently used the extended anterolateral approach in posterolateral tibial plateau fracture. We compared the clinical effects of this method in Schatzker type II or type V/VI fractures with posterolateral tibial plateau fracture based on our patients. Methods The patients from January 2013 to December 2015 were summarized, and some of them were assisted with arthroscopy. According to Schatzker classification, patients with Schatzker type II fracture were divided into group A; patients with Schatzker type V/VI fracture were divided into group B. The fracture characteristics, operation statistics, and postoperative functional evaluation of each group were compared. Results A total of 46 patients were included in the study and were followed up for 23–45 months. There were 24 cases in group A and 22 cases in group B. The operation time and the amount of bleeding were significantly less in group A (P < 0.05). Twelve cases were assisted with arthroscopy including 6 patients in each group. The fracture healing time made no significant difference in the two groups (P > 0.05). All patients experienced no significant influence on daily life. The knee Rasmussen score was 26.8 in group A and 23.5 in group B (P > 0.05), and the knee range motion was 115.5° in group A and 106.6° in group B (P > 0.05). The excellent and good rate of reduction was 91.7% in group A and 81.8% in group B (P > 0.05), but the excellent rate of reduction was 83.3% in group A and 27.3% in group B (P < 0.05). The unfixed rate of posterolateral fracture was 16.7% in group A and 36.4% in group B (P > 0.05). One patient in group B suffered postoperative wound infection. Conclusions The extended anterolateral approach could obtain similar satisfactory clinical results in simple/complex tibial plateau fracture with posterolateral tibial plateau fracture. It seemed that easier operation, better posterolateral fracture reduction, and fixation occurred in relative simple fracture from our cases. Trial registration It was a retrospective study. This study was consistent with the ethical standards of the Second Affiliated Hospital of Zhejiang University Medical College and was approved by the hospital ethics committee and the trial registration number of our hospital was 20170053.
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spelling doaj.art-2bac3319467b4267abca1d9eb74a20cb2022-12-22T02:20:20ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2018-11-011311810.1186/s13018-018-1007-7Comparison of extended anterolateral approach in treatment of simple/complex tibial plateau fracture with posterolateral tibial plateau fractureLiangjun Jiang0Qiang Zheng1Zhijun Pan2The Orthopedics Department of 2nd Affiliated Hospital of Medical, College of Zhejiang UniversityThe Orthopedics Department of 2nd Affiliated Hospital of Medical, College of Zhejiang UniversityThe Orthopedics Department of 2nd Affiliated Hospital of Medical, College of Zhejiang UniversityAbstract Background Our hospital has recently used the extended anterolateral approach in posterolateral tibial plateau fracture. We compared the clinical effects of this method in Schatzker type II or type V/VI fractures with posterolateral tibial plateau fracture based on our patients. Methods The patients from January 2013 to December 2015 were summarized, and some of them were assisted with arthroscopy. According to Schatzker classification, patients with Schatzker type II fracture were divided into group A; patients with Schatzker type V/VI fracture were divided into group B. The fracture characteristics, operation statistics, and postoperative functional evaluation of each group were compared. Results A total of 46 patients were included in the study and were followed up for 23–45 months. There were 24 cases in group A and 22 cases in group B. The operation time and the amount of bleeding were significantly less in group A (P < 0.05). Twelve cases were assisted with arthroscopy including 6 patients in each group. The fracture healing time made no significant difference in the two groups (P > 0.05). All patients experienced no significant influence on daily life. The knee Rasmussen score was 26.8 in group A and 23.5 in group B (P > 0.05), and the knee range motion was 115.5° in group A and 106.6° in group B (P > 0.05). The excellent and good rate of reduction was 91.7% in group A and 81.8% in group B (P > 0.05), but the excellent rate of reduction was 83.3% in group A and 27.3% in group B (P < 0.05). The unfixed rate of posterolateral fracture was 16.7% in group A and 36.4% in group B (P > 0.05). One patient in group B suffered postoperative wound infection. Conclusions The extended anterolateral approach could obtain similar satisfactory clinical results in simple/complex tibial plateau fracture with posterolateral tibial plateau fracture. It seemed that easier operation, better posterolateral fracture reduction, and fixation occurred in relative simple fracture from our cases. Trial registration It was a retrospective study. This study was consistent with the ethical standards of the Second Affiliated Hospital of Zhejiang University Medical College and was approved by the hospital ethics committee and the trial registration number of our hospital was 20170053.http://link.springer.com/article/10.1186/s13018-018-1007-7Posterolateral tibial plateau fractureExtended anterolateral approachArthroscopy treatmentFracture reduction and fixation
spellingShingle Liangjun Jiang
Qiang Zheng
Zhijun Pan
Comparison of extended anterolateral approach in treatment of simple/complex tibial plateau fracture with posterolateral tibial plateau fracture
Journal of Orthopaedic Surgery and Research
Posterolateral tibial plateau fracture
Extended anterolateral approach
Arthroscopy treatment
Fracture reduction and fixation
title Comparison of extended anterolateral approach in treatment of simple/complex tibial plateau fracture with posterolateral tibial plateau fracture
title_full Comparison of extended anterolateral approach in treatment of simple/complex tibial plateau fracture with posterolateral tibial plateau fracture
title_fullStr Comparison of extended anterolateral approach in treatment of simple/complex tibial plateau fracture with posterolateral tibial plateau fracture
title_full_unstemmed Comparison of extended anterolateral approach in treatment of simple/complex tibial plateau fracture with posterolateral tibial plateau fracture
title_short Comparison of extended anterolateral approach in treatment of simple/complex tibial plateau fracture with posterolateral tibial plateau fracture
title_sort comparison of extended anterolateral approach in treatment of simple complex tibial plateau fracture with posterolateral tibial plateau fracture
topic Posterolateral tibial plateau fracture
Extended anterolateral approach
Arthroscopy treatment
Fracture reduction and fixation
url http://link.springer.com/article/10.1186/s13018-018-1007-7
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AT zhijunpan comparisonofextendedanterolateralapproachintreatmentofsimplecomplextibialplateaufracturewithposterolateraltibialplateaufracture