Severe tibial plateau fractures (Schatzker V–VI): open reduction and internal fixation versus hybrid external fixation

Tibial plateau fractures (TPF) are highly prone to complications and adverse effects. Their treatment has long been a matter of controversy, as fracture patterns and possible damage to soft tissues can easily aggravate complications. On the one hand, open reduction and internal fixation (ORIF) techn...

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Bibliographic Details
Published in:Injury 2017-11, Vol.48, p.S81-S85
Main Authors: Bertrand, Maria L., Pascual-López, F. Javier, Guerado, Enrique
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
bycondylar tibial fractures
double plating
External Fixators
Female
Fracture Fixation
Fracture Fixation, Internal
high-energy fractures
Humans
hybrid external fixation
Male
Middle Aged
Open Fracture Reduction
Prospective Studies
proximal tibia fractures
Radiography
Range of Motion, Articular
Soft Tissue Injuries - surgery
Surgical Wound Infection - prevention & control
Tibial Fractures - complications
Tibial Fractures - diagnostic imaging
Tibial Fractures - surgery
Treatment Outcome
Young Adult
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Summary:Tibial plateau fractures (TPF) are highly prone to complications and adverse effects. Their treatment has long been a matter of controversy, as fracture patterns and possible damage to soft tissues can easily aggravate complications. On the one hand, open reduction and internal fixation (ORIF) techniques provide a good approach to joint shape restoration and biomechanics, but they may also provoke a higher rate of soft-tissue complications. On the other, hybrid external fixation (HEF), although allowing little facility for reduction, may, theoretically, produce much less damage to the soft tissues. We present 93 cases of TPF classified as type V or VI that were followed up for at least 24 months. There were no statistical differences among them in relation to consolidation, secondary malalignment or range of motion, according to whether ORIF or HEF was employed. However, when external fixation followed open reduction, both superficial and deep-infection rates were higher.
ISSN:0020-1383
1879-0267
DOI:10.1016/S0020-1383(17)30799-4