SURGICAL TREATMENT OF TIBIAL PLATEAU FRACTURES

Abstract

Objectives. Tibial plateau fractures represent approximately 1% of the total fractures, in the general population, and 8% among the senile age population. The aim of the study was to analyze of methods and results of surgical treatment of patients with tibial plateau fractures.
Material and Methods. We analyzed clinical cases of 110 patients – 60 women and 50 men, treated in the Orthopedics and traumatology Clinic "Vitalie Bețișor", Chișinău, Republic of Moldova, during 2014-2019 years. There was used the classification of fractures, according to Schatzker, so that type I were 10 cases, type II – 30, type III – 15, type IV – 10, type V – 30, type VI – 15. Out of the whole lot of patients, 105 fractures were closed and only 5 – open. The surgical treatment consisted of closed reduction in 15 cases: osteosynthesis with screws – 9, external fixator – 6 and open reduction with internal osteosynthesis in 95 cases.
Results. Patients were evaluated clinically and by imaging, at a period of 6, 12, 18 and 24 weeks postoperatively, the functional result being assessed according to the Lysholm Knee Scoring Scale, obtaining an average result of 88 points. Bone healing was determined between 12 and 18 weeks. Various postoperative complications developed in 17 patients. The results were dependent on the approaches, used surgical techniques, the type and stability of the osteosynthesis, the precocity and correctness of the functional recovery, and the compliance of the patients.
Conclusion. Favorable results, as well as easier and fewer complications, were observed in cases of individual surgical treatment, optimal choice of approaches, less invasive surgical techniques, implants, stable osteosynthesis, early and correct functional recovery.