The results of tibial plateau fractures that were treated operatively

Abstract

35 patients with plateau fractures were treated operatively between January 1992- December 1995, in our department. 24 patients whom we could have enough follow-up were included in the study. There were 6 women and 18 men. The average age was 37.1 (28-60). The average duration of follow-up was 18.5 months (6-48 months). 5 patients had additional injuries besides tibial plateau fractures. 3 of the cases were open fractures. Plate-screw was applied to 11 cases, plate-screw-grafting was applied to 6 cases, screw was applied to 5 cases, Ilizarov was applied to one case and external fixator was applied to the other one. In addition, meniscectomy was performed in 5 patients. The fractures were reviewed according to Hohl and Moore classification. Our cases were classified as 2 type I, 1 type II, 13 type III, 2 type IV and 6 type V. The patients were evaluated according to the criteria of Rasmussen and the modified version of criteria of Hohl and Luck. Our results were excellent, 11 good, 5 fair and 4 poor according to the classification of Hohl and Luck. We concluded that, to gain a functional knee joint in the displaced and unstable tibial plateau fractures, anatomical reduction, stable internal fixation, and early motion are necessary.

Özet

Kliniğimizde, Ocak 1992- Aralık 1995 tarihleri arasında, tibia plato kırığı olan 35 hasta cerrahi yön-temlerle tedavi edildi. Yeterli takibi yapılabilen 24 hasta çalışmaya alındı. Olguların 6 sı kadın, 18 i erkekti. Ortalama yaş 37.1 (28-60) idi. Ortalama takip süresi 18.5 ay (6-48 ay) olarak saptandı. 5 hastada, tibia pla-to kırığına ilave yaralanmalar vardı. 3 olgudaki yaralanma açık kırık şeklindeydi. Olgular uygulanan cerra-hi yönteme göre değerlendirildiklerinde; 11 olguya plak-vida, 6 olguya piak-vida-greftle takviye, 5 olguya vida, bir olguya İlizarov ve bir diğer olguya eksternal fiksatör uygulandığı belirlendi, ilave olarak 5 hastaya menisektomi yapı idi. Kırıklar Hohl ve Moore sınıflamasına göre değerlendirildi. Bu sınıflamaya göre, 2 olgu tip I, 1 olgu tip II, 13 olgu tip III, 2 olgu tip IV ve 6 olgu tip V olarak değerlendirildi. Hastalar son kontrollerinde Rasmussen kriterieriyle modifiye Hohl ve Luck değerlendirme kriterlerine göre değerlendirildiler. Hohl ve Luck kriterlerine göre: 4 olguda mükemmel, 11 olguda iyi, 5 olguda orta ve 4 olguda kötü sonuç saptadık. Deplase ve instabil tibia plato kırıklarında fonksiyonel bir diz elde edebilmek için, anatomik redak-siyon ve stabil internal fiksasyon ile erken dönemde hareket verme gerekliliği sonucuna varıldı.