Failure analysis of primary surgery and therapeutic strategy of revision surgery for complex tibial plateau fractures
Abstract Purpose To analyze the cause of failure of the primary surgery for complex tibial plateau fractures and to define the therapeutic strategy of the revision surgery for the same. Methods Twenty-one cases with failure of primary surgery for complex tibial plateau fractures were treated in our...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-04-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-019-1147-4 |
| _version_ | 1798006345900752896 |
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| author | Zhe Song Qian Wang Teng Ma Chen Wang Na Yang Hanzhong Xue Zhong Li Yangjun Zhu Kun Zhang |
| author_facet | Zhe Song Qian Wang Teng Ma Chen Wang Na Yang Hanzhong Xue Zhong Li Yangjun Zhu Kun Zhang |
| author_sort | Zhe Song |
| collection | DOAJ |
| description | Abstract Purpose To analyze the cause of failure of the primary surgery for complex tibial plateau fractures and to define the therapeutic strategy of the revision surgery for the same. Methods Twenty-one cases with failure of primary surgery for complex tibial plateau fractures were treated in our hospital from January 2012 to September 2016. There were 13 males and 8 females with an average age of 39.4 years (ranged between 27 and 58 years). Patients presented with different types of complex tibial plateau fractures like Schatzker type V (n=9), VI (n=12), type 41.C1 (n=9), type 41.C2 (n=6), and type 41.C3 (n=6). The therapeutic strategy for revision surgery in individual patients was decided following careful analysis and accurate assessment of the causes of failure of the primary surgery. All the patients were followed-up with Rasmussen radiographic scores and Hospital for Special Surgery (HSS) knee scores. Results All 21 patients underwent clinical and radiological examination after a mean follow-up time of 32.6 months. The average time of fracture healing was 4.5 months (ranged between 3 and 6 months). During the last follow-up, the mean range of motion of knee extension was 2.3° and knee flexion was 123.8°. The mean radiological Rasmussen score was 15.6 points, with an overall success rate of 85.7%. The average HSS knee score was 84.3 points, with an overall success rate of 80.9%. Conclusion The common reasons for the failure of primary surgery of complex tibial plateau fractures were inadequate experience of the surgeon, inaccurate diagnosis and management, improper selection of implants, and poor surgical techniques. The key factors to succeed revision surgery were adequate preoperative evaluation, accurate intraoperative procedures, and proper postoperative rehabilitation. Level of evidence Level IV, case series, treatment study |
| first_indexed | 2024-04-11T12:53:18Z |
| format | Article |
| id | doaj.art-dbc5aab0d94b4a9bb1f860fcf3bf4349 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T12:53:18Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-dbc5aab0d94b4a9bb1f860fcf3bf43492022-12-22T04:23:08ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2019-04-011411710.1186/s13018-019-1147-4Failure analysis of primary surgery and therapeutic strategy of revision surgery for complex tibial plateau fracturesZhe Song0Qian Wang1Teng Ma2Chen Wang3Na Yang4Hanzhong Xue5Zhong Li6Yangjun Zhu7Kun Zhang8Department of Orthopaedic Trauma, Hong-Hui Hospital, Xi’an Jiaotong UniversityDepartment of Orthopaedic Trauma, Hong-Hui Hospital, Xi’an Jiaotong UniversityDepartment of Orthopaedic Trauma, Hong-Hui Hospital, Xi’an Jiaotong UniversityDepartment of Orthopaedic Trauma, Hong-Hui Hospital, Xi’an Jiaotong UniversityDepartment of Orthopaedic Trauma, Hong-Hui Hospital, Xi’an Jiaotong UniversityDepartment of Orthopaedic Trauma, Hong-Hui Hospital, Xi’an Jiaotong UniversityDepartment of Orthopaedic Trauma, Hong-Hui Hospital, Xi’an Jiaotong UniversityDepartment of Orthopaedic Trauma, Hong-Hui Hospital, Xi’an Jiaotong UniversityDepartment of Orthopaedic Trauma, Hong-Hui Hospital, Xi’an Jiaotong UniversityAbstract Purpose To analyze the cause of failure of the primary surgery for complex tibial plateau fractures and to define the therapeutic strategy of the revision surgery for the same. Methods Twenty-one cases with failure of primary surgery for complex tibial plateau fractures were treated in our hospital from January 2012 to September 2016. There were 13 males and 8 females with an average age of 39.4 years (ranged between 27 and 58 years). Patients presented with different types of complex tibial plateau fractures like Schatzker type V (n=9), VI (n=12), type 41.C1 (n=9), type 41.C2 (n=6), and type 41.C3 (n=6). The therapeutic strategy for revision surgery in individual patients was decided following careful analysis and accurate assessment of the causes of failure of the primary surgery. All the patients were followed-up with Rasmussen radiographic scores and Hospital for Special Surgery (HSS) knee scores. Results All 21 patients underwent clinical and radiological examination after a mean follow-up time of 32.6 months. The average time of fracture healing was 4.5 months (ranged between 3 and 6 months). During the last follow-up, the mean range of motion of knee extension was 2.3° and knee flexion was 123.8°. The mean radiological Rasmussen score was 15.6 points, with an overall success rate of 85.7%. The average HSS knee score was 84.3 points, with an overall success rate of 80.9%. Conclusion The common reasons for the failure of primary surgery of complex tibial plateau fractures were inadequate experience of the surgeon, inaccurate diagnosis and management, improper selection of implants, and poor surgical techniques. The key factors to succeed revision surgery were adequate preoperative evaluation, accurate intraoperative procedures, and proper postoperative rehabilitation. Level of evidence Level IV, case series, treatment studyhttp://link.springer.com/article/10.1186/s13018-019-1147-4Tibial plateau fractureKnee jointFracture fixationProximal tibiaRevision surgery |
| spellingShingle | Zhe Song Qian Wang Teng Ma Chen Wang Na Yang Hanzhong Xue Zhong Li Yangjun Zhu Kun Zhang Failure analysis of primary surgery and therapeutic strategy of revision surgery for complex tibial plateau fractures Journal of Orthopaedic Surgery and Research Tibial plateau fracture Knee joint Fracture fixation Proximal tibia Revision surgery |
| title | Failure analysis of primary surgery and therapeutic strategy of revision surgery for complex tibial plateau fractures |
| title_full | Failure analysis of primary surgery and therapeutic strategy of revision surgery for complex tibial plateau fractures |
| title_fullStr | Failure analysis of primary surgery and therapeutic strategy of revision surgery for complex tibial plateau fractures |
| title_full_unstemmed | Failure analysis of primary surgery and therapeutic strategy of revision surgery for complex tibial plateau fractures |
| title_short | Failure analysis of primary surgery and therapeutic strategy of revision surgery for complex tibial plateau fractures |
| title_sort | failure analysis of primary surgery and therapeutic strategy of revision surgery for complex tibial plateau fractures |
| topic | Tibial plateau fracture Knee joint Fracture fixation Proximal tibia Revision surgery |
| url | http://link.springer.com/article/10.1186/s13018-019-1147-4 |
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