Clinical Original Article
The value of cross raft screws technique to prevent postoperative collapse of tibial plateau fracture
Zhang Xi, Sun Jie, Li Fangguo, Hu Yongcheng, Ma Baotong, Lu Yandong, Lu Jie, Guo Lin, Cui Meng, Wei Xuelei, Liu Yunjiao
Published 2018-08-01
Cite as Chin J Orthop, 2018,38(15): 897-904. DOI: 10.3760/cma.j.issn.0253-2352.2018.15.001
Abstract
ObjectiveTo assess the clinical value of cross raft screws technique in preventing postoperative collapse of tibial plateau fracture.
MethodsFrom September 2014 to November 2017, data of 14 patients with tibial plateau fracture who were treated by cross raft screws technique were retrospectively analyzed. There were 9 males and 5 females aged from 30-65 years old (average, 44.4±1.7 years). There were 8 patients that the thickness of subchondral cancellous bone measured preoperatively by CT data was less than 4 mm, and 6 patients that the thickness of subchondral cancellous bone measured intraoperatively was less than 4 mm. 1/4 tubular plate was placed along the anterior rim of lateral tibial plateau, and the 3.5 mm cortical bone screws were fixed as bamboo raft from anterior to posterior through the plate. The collapse of tibial plateau after surgery were measured by CT scan after union of the fracture. The function of knee was evaluated by Rasmussen Anatomical and Functional Grading.
ResultsThe time of tubular plate procedure was 18 to 35 min (average, 24.1±5.4 min). All 14 patients were successfully followed-up for 13.8±5.1 months. The height of collapse preoperatively by CT scan was 5-21 mm (average, 8.00±1.40 mm). 3 days after the operation, the height between articular line and lateral articular surface was 0-2 mm (average, 0.80±0.06 mm). Compared with CT data preoperatively, the collapse was corrected postoperatively that was proved by CT scan (P< 0.05). After the fracture was healed, according to CT data, the height between articular line and lateral articular surface was 0-2 mm (average, 0.70±0.08 mm). Compared with CT data postoperatively, there was no postoperative collapse happened (P=0.466). The position and length of nails were placed appropriately. The average healing time of fracture was 3.6 months. There were no infection, nonunion and pain of tendon happened. The plate could be touched subcutaneously in 2 patients, who had no discomfort feelings. The patient's postoperative Rasmussen Anatomical Grading were 13-18 (average, 16.7), including 8 cases excellent and 6 cases good. The postoperative Rasmussen Functional Grading was 18-28 (average, 25.7), including 11 cases excellent and 3 cases good.
ConclusionThe cross raft screws technique is a good way to prevent the postoperative collapse of the lateral articular surface of tibial plateau.
Key words:
Tibial fractures; Fracture fixation, internal; Treatment outcome
Contributor Information
Zhang Xi
Department II of Knee Traumatic Orthopaedics, Tianjin Hospital, Tianjin 300211, China
Sun Jie
Department II of Knee Traumatic Orthopaedics, Tianjin Hospital, Tianjin 300211, China
Li Fangguo
Department II of Knee Traumatic Orthopaedics, Tianjin Hospital, Tianjin 300211, China
Hu Yongcheng
Department of Bone Oncology, Tianjin Hospital, Tianjin 300211, China
Ma Baotong
Department II of Knee Traumatic Orthopaedics, Tianjin Hospital, Tianjin 300211, China
Lu Yandong
Department II of Knee Traumatic Orthopaedics, Tianjin Hospital, Tianjin 300211, China
Lu Jie
Department II of Knee Traumatic Orthopaedics, Tianjin Hospital, Tianjin 300211, China
Guo Lin
Radiology Department, Tianjin Hospital, Tianjin 300211, China
Cui Meng
Department II of Knee Traumatic Orthopaedics, Tianjin Hospital, Tianjin 300211, China
Wei Xuelei
Department II of Knee Traumatic Orthopaedics, Tianjin Hospital, Tianjin 300211, China
Liu Yunjiao
Department II of Knee Traumatic Orthopaedics, Tianjin Hospital, Tianjin 300211, China
