Introduction of 3D-classification and its derived surgical sequence of Schatzker type IV tibial plateau fractures
Abstract Introduction Schatzker IV tibial plateau fractures usually have a worse prognosis due to their high variability and the accompanied bony and soft tissue injuries. This study aimed to introduce an injury mechanism-based new classification of Schatzker IV tibial plateau fractures and evaluate...
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| Fformat: | Erthygl |
| Iaith: | English |
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BMC
2023-12-01
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| Cyfres: | BMC Surgery |
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| Mynediad Ar-lein: | https://doi.org/10.1186/s12893-023-02284-0 |
| _version_ | 1827590779654111232 |
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| author | Zihao Liu Yanlong Zhang Shengjie Wang Shuai Wang AQin Peng |
| author_facet | Zihao Liu Yanlong Zhang Shengjie Wang Shuai Wang AQin Peng |
| author_sort | Zihao Liu |
| collection | DOAJ |
| description | Abstract Introduction Schatzker IV tibial plateau fractures usually have a worse prognosis due to their high variability and the accompanied bony and soft tissue injuries. This study aimed to introduce an injury mechanism-based new classification of Schatzker IV tibial plateau fractures and evaluate its reliability. Additionally, this study aimed to evaluate the outcomes of operative Schatzker IV tibial plateau fractures treated according to the surgical sequences determined by the new classification. Materials and methods A total of 63 cases of operative Schatzker IV tibial plateau fractures that were treated following the new surgical sequences were enrolled in our study. The CT images of these patients were reviewed and classified twice according to the new 3D classification by 4 independent observers. The reliability of the classification was calculated through kappa analysis. The classification-determined surgical sequence was evaluated by observing the postoperative efficacy during the follow-up. Results Both the intra-observer (the mean k = 0.897, CI 0.806–0.971) and inter-observer (the mean k = 0.883, CI 0.786–0.961) reliability of 3D-classification showed excellent agreement according to Landis and Koch. All the patients were followed up for 6–28 months (average 12.8 months). As for the evaluation of the postoperative efficacy, according to KSS, 53 cases were rated as excellent, 8 cases as good, and 2 cases as fair results. Conclusions The new proposed classification showed high intra-observer and inter-observer reliability in our study. The surgical sequence determined by the classification can help surgeons to acquire good reduction and rigid internal fixation. Therefore the new classification of Schatzker IV tibial plateau fractures and the derived surgical sequences are worthy of further popularization and application in clinical trials. |
| first_indexed | 2024-03-09T01:21:35Z |
| format | Article |
| id | doaj.art-8826d9ad1601425c982dc59bb001a5f5 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-03-09T01:21:35Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-8826d9ad1601425c982dc59bb001a5f52023-12-10T12:05:38ZengBMCBMC Surgery1471-24822023-12-0123111610.1186/s12893-023-02284-0Introduction of 3D-classification and its derived surgical sequence of Schatzker type IV tibial plateau fracturesZihao Liu0Yanlong Zhang1Shengjie Wang2Shuai Wang3AQin Peng4Department of Orthopaedic Trauma, Harrison International Peace HospitalDepartment of Trauma Surgery, First Hospital of Hebei Medical UniversityDepartment of Orthopaedic Trauma, Harrison International Peace HospitalDepartment of Orthopaedic Surgery, Hebei Chest HospitalDepartment of Orthopaedic Surgery, Third Hospital of Hebei Medical UniversityAbstract Introduction Schatzker IV tibial plateau fractures usually have a worse prognosis due to their high variability and the accompanied bony and soft tissue injuries. This study aimed to introduce an injury mechanism-based new classification of Schatzker IV tibial plateau fractures and evaluate its reliability. Additionally, this study aimed to evaluate the outcomes of operative Schatzker IV tibial plateau fractures treated according to the surgical sequences determined by the new classification. Materials and methods A total of 63 cases of operative Schatzker IV tibial plateau fractures that were treated following the new surgical sequences were enrolled in our study. The CT images of these patients were reviewed and classified twice according to the new 3D classification by 4 independent observers. The reliability of the classification was calculated through kappa analysis. The classification-determined surgical sequence was evaluated by observing the postoperative efficacy during the follow-up. Results Both the intra-observer (the mean k = 0.897, CI 0.806–0.971) and inter-observer (the mean k = 0.883, CI 0.786–0.961) reliability of 3D-classification showed excellent agreement according to Landis and Koch. All the patients were followed up for 6–28 months (average 12.8 months). As for the evaluation of the postoperative efficacy, according to KSS, 53 cases were rated as excellent, 8 cases as good, and 2 cases as fair results. Conclusions The new proposed classification showed high intra-observer and inter-observer reliability in our study. The surgical sequence determined by the classification can help surgeons to acquire good reduction and rigid internal fixation. Therefore the new classification of Schatzker IV tibial plateau fractures and the derived surgical sequences are worthy of further popularization and application in clinical trials.https://doi.org/10.1186/s12893-023-02284-0ClassificationSchatzker type IV tibial plateau fracturesSurgical sequence |
| spellingShingle | Zihao Liu Yanlong Zhang Shengjie Wang Shuai Wang AQin Peng Introduction of 3D-classification and its derived surgical sequence of Schatzker type IV tibial plateau fractures BMC Surgery Classification Schatzker type IV tibial plateau fractures Surgical sequence |
| title | Introduction of 3D-classification and its derived surgical sequence of Schatzker type IV tibial plateau fractures |
| title_full | Introduction of 3D-classification and its derived surgical sequence of Schatzker type IV tibial plateau fractures |
| title_fullStr | Introduction of 3D-classification and its derived surgical sequence of Schatzker type IV tibial plateau fractures |
| title_full_unstemmed | Introduction of 3D-classification and its derived surgical sequence of Schatzker type IV tibial plateau fractures |
| title_short | Introduction of 3D-classification and its derived surgical sequence of Schatzker type IV tibial plateau fractures |
| title_sort | introduction of 3d classification and its derived surgical sequence of schatzker type iv tibial plateau fractures |
| topic | Classification Schatzker type IV tibial plateau fractures Surgical sequence |
| url | https://doi.org/10.1186/s12893-023-02284-0 |
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