CT based management of high energy tibial plateau fractures: A retrospective review of 53 cases |
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| Affiliation: | 1. University of Alabama School of Medicine, 670 University Blvd, Birmingham, AL 35233, USA;2. Department of Orthopedic Surgery, University of Alabama School of Medicine, 1313 13th Street South, Birmingham, AL 35294, USA;3. Department of Orthopedic Surgery, Indraprastha Apollo Hospital, New Delhi, India;1. Departments of Anesthesiology, SUNY Downstate Medical Center, Brooklyn, NY, United States;2. Departments of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, NY, United States;3. Department of Orthopaedics, University of Maryland Medical Center, Baltimore, MD, United States;1. P.D Hinduja Hospital and Medical Research Centre, Mumbai, India;2. Department of Orthopedics, P.D Hinduja Hospital and Medical Research Centre, Mumbai, India;1. Clinic of Orthopaedic Surgery and Traumatology, University Hospital Nis, Bul. Dr Z. Djindjic 48, 18000 Nis, Serbia;2. National Academy of Medical Science, Medical Faculty, University of Nis, Serbia, Bul. Dr Z. Djindjic 81, 18000 Nis, Serbia |
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| Abstract: | ObjectivesThe management of high energy tibial plateau fractures is a surgical challenge. Recently described Luo’s classification is based on CT scans and is more objective with a better inter-observer agreement as compare to Schatzker and AO/OTA classifications. We describe the functional results of a series of 53 cases classified and managed according to the Luo’s column concept.MethodsA retrospective review of 53 high energy tibial plateau fractures, operated between January 2012 and March 2015 at a Level I trauma center, was performed. CT scans were used to classify these injuries based on the number of columns involved. Plating configuration and surgical approach were chosen based on the number of independent articular fragments on axial sections at the level of fibular head.Results1 one-column, 51 two-column and 1 three-column fractures were studied. Triple plating was done in 5 patients. Mean follow-up was 2.7 years and mean Insall Knee score was 95.42. Four patients had varus malalignment and 1 had joint depression in the post-operative period. These were due to imperfect reduction during the surgery itself, and no case of late collapse was detected.ConclusionUtilizing Luo’s classification for treating these complex injuries will assist in better understanding of fracture pattern and hence help in achieving a better functional outcome. Each fractured column needs to be independently addressed. |
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| Keywords: | High energy Tibial plateau fractures Luo’s classification Column concept |
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