Postoperative Evaluation of Tibial Plateau Fractures.

概要

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To document problems of operative treatment, we evaluated postoperative results of 30 patients with tibial plateau fractures.Patients included 17 males and 13 females, with a mean age of 49 years, ranging from 17 to 78. The average follow-up period was 15 months, ranging from 6 to 54 months. Following the principle of Hohl, there were 4 minimally displaced fractures, one with local depression, 9 with split depression, 3 with total depression, and 13 comminuted fractures. These patients were treated by open reduction and internal fixation with a cannulated cancellous screw, with a plate, or with a tibia bolt.According to the evaluation of Hohl & Luck, excellent and good results were achieved in 83%. Fair and poor results were seen in the split depression group or in the comminuted fracture group. These cases had a depression of more than 5mm in depth, located from the central to posterior region of the weight bearing area, except 2 miserable comminuted fractures.We think anatomical reduction of joint surfaces is most important, as mentioned by other investigators. However, it is difficult to verify posterior joint surfaces in common surgical approaches. We must take care to remember this point during open reduction.