In-Jung Chae; Sang-Won Park; Soon-Hyuck Lee; Won Noh; Ho-Joong Kim; Seung-Beom Hahn

doi:10.12671/jkfs.2009.22.4.252

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Original Article
Treatment of Shatzker Type VI Tibia Plateau Fracture Using Lateral and Posteromedial Dual Incision Approach and Dual Plating: In-Jung Chae, M.D., Sang-Won Park, M.D., Soon-Hyuck Lee, M.D., Won Noh, M.D., Ho-Joong Kim, M.D., Seung-Beom Hahn, M.D.; Journal of the Korean Fracture Society 2009;22(4):252-258.
DOI: https://doi.org/10.12671/jkfs.2009.22.4.252
Published online: October 30, 2009

Department of Orthopaedic Surgery, Korea University Anam Hospital, Seoul, Korea.

Address reprint requests to: Seung-Beom Hahn, M.D. Department of Orthopaedic Surgery, Korea University Anam Hospital, 126-1, Anam-dong 5-ga, Seongbuk-gu, Seoul 136-705, Korea. Tel: 82-2-920-5924, Fax: 82-2-924-2471, oshan@korea.ac.kr

• Received: November 30, 2008 • Revised: March 9, 2009 • Accepted: September 21, 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

Abstract

Purpose
To evaluate the radiologic and clinical results of treatment of the Shatzker type 6 tibia plateau fracture using the lateral and posteromedial dual incision approach and dual plating.
Materials and Methods
Twelve cases in eleven patients of Shatzker type 6 tibia plateau fracture which has been treated using the lateral and posteromedial dual incision approach and dual plating were analyzed with an average follow-up of 16 months. Times to union, alignment and reduction loss on radiograph and postoperative clinical outcome with checking the range of motion of the knee joint, Knee Society Score and UCLA activity scale were analyzed and evaluated.
Results
In all cases, bony union was obtained in an average fifteen weeks after the operation, and there was no reduction loss. The arc of motion of the knee joint at the latest follow-up was 132 degrees on average. Average of Knee Society Score was 85 and UCLA activity scale was decreased from 9.6 points preoperatively to 5.7 points postoperatively.
Conclusion
The treatment of Shatzker type 6 tibia plateau fracture using the lateral and posteromedial dual approach and dual plating have shown clinically preferable results of excellent recovery of joint motion and good knee society score by early range of motion exercise after firm fixation. However, it was high energy injury, so the sports activity of patients was significantly decreased.
Key words: Tibia plateau fracture, Shatzker type 6, Dual incision approach and plating

REFERENCES

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4. Georgiadis GM. Combined anterior and posterior approaches for complex tibial plateau fractures. J Bone Joint Surg Br, 1994;76:285-289.Article PDF
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8. Jiang R, Luo CF, Wang MC, Yang TY, Zeng BF. A comparative study of Less Invasive Stabilization System (LISS) fixation and two-incision double plating for the treatment of bicondylar tibial plateau fractures. Knee, 2008;15:139-143.Article
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Fig. 1

(A) Posteromedial approach.

(B) Lateral submeniscal approach.

Fig. 2

(A) Preoperative MPTA.

(B) Postoperative MPTA.

Fig. 3

37 years old patient who sustained crushing injury.

(A) Plain radiograph showing complex tibial plateau fracture (Shatzker type VI).

(B) 3D-CT scan (coronal view).

Fig. 4

(A) Immediate postoperative plain radiographs showing dual plating.

(B) Postoperative 12 months follow-up showing complete union state and normal alignment of knee joint.

Fig. 5

57 years old male patient who sustained traffic accident.

(A) Plain radiograph showing complex tibial plateau fracture (Shatzker type VI).

(B) 3D-CT scan (coronal view).

Fig. 6

(A) Immediate postoperative plain radiographs showing dual plating.

(B) Postoperative 15 months follow-up showing complete union state and normal alignment of knee joint.

Fig. 7

In postoperative 18 months follow-up photographs, the patient recovered the full range of motion but UCLA activity scale was decreased significantly (A) the patient can extend the knee in full degrees (B) the patient can flex the knee in full degrees.

Table 1

Demographics

^*The same patient who sustained the bilateral tibia plateau fracture, case no. 6 and 7 indicates right and left knee joint respectively.

Table 2

UCLA scale

Table 3

Clinical results

^*The same patient who sustained the bilateral tibia plateau fracture, case no. 6 and 7 indicates right and left knee joint respectively.

Figure & Data

REFERENCES

Citations

Citations to this article as recorded by

Staged Treatment of Bicondylar Tibial Plateau Fracture (Schatzker Type V or VI) Using Temporary External Fixator: Correlation between Clinical and Radiological Outcomes
Seung Min Ryu, Han Seok Yang, Oog Jin Shon
Knee Surgery and Related Research.2018; 30(3): 261. CrossRef
Medial Minimally Invasive Percutaneous Plate Osteosynthesis in Proximal Tibial Comminuted Fractures
Jae-Ang Sim, Kwang-Hui Kim, Yong-Seuk Lee, Sang-Jin Lee, Beom-Koo Lee
Journal of the Korean Orthopaedic Association.2014; 49(4): 278. CrossRef
Current Concepts in Management of Tibia Plateau Fracture
Sang Hak Lee, Kang-Il Kim
Journal of the Korean Fracture Society.2014; 27(3): 245. CrossRef

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Treatment of Shatzker Type VI Tibia Plateau Fracture Using Lateral and Posteromedial Dual Incision Approach and Dual Plating

J Korean Fract Soc. 2009;22(4):252-258. Published online October 31, 2009

DOI: https://doi.org/10.12671/jkfs.2009.22.4.252

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Treatment of Shatzker Type VI Tibia Plateau Fracture Using Lateral and Posteromedial Dual Incision Approach and Dual Plating

Fig. 1 (A) Posteromedial approach. (B) Lateral submeniscal approach.

Fig. 2 (A) Preoperative MPTA. (B) Postoperative MPTA.

Fig. 3 37 years old patient who sustained crushing injury. (A) Plain radiograph showing complex tibial plateau fracture (Shatzker type VI). (B) 3D-CT scan (coronal view).

Fig. 4 (A) Immediate postoperative plain radiographs showing dual plating. (B) Postoperative 12 months follow-up showing complete union state and normal alignment of knee joint.

Fig. 5 57 years old male patient who sustained traffic accident. (A) Plain radiograph showing complex tibial plateau fracture (Shatzker type VI). (B) 3D-CT scan (coronal view).

Fig. 6 (A) Immediate postoperative plain radiographs showing dual plating. (B) Postoperative 15 months follow-up showing complete union state and normal alignment of knee joint.

Fig. 7 In postoperative 18 months follow-up photographs, the patient recovered the full range of motion but UCLA activity scale was decreased significantly (A) the patient can extend the knee in full degrees (B) the patient can flex the knee in full degrees.

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Fig. 5

Fig. 6

Fig. 7

Treatment of Shatzker Type VI Tibia Plateau Fracture Using Lateral and Posteromedial Dual Incision Approach and Dual Plating

Table 1

Demographics

^*The same patient who sustained the bilateral tibia plateau fracture, case no. 6 and 7 indicates right and left knee joint respectively.

Table 2

UCLA scale

Table 3

Clinical results

^*The same patient who sustained the bilateral tibia plateau fracture, case no. 6 and 7 indicates right and left knee joint respectively.

Table 1 Demographics

^*The same patient who sustained the bilateral tibia plateau fracture, case no. 6 and 7 indicates right and left knee joint respectively.

Table 2 UCLA scale

Table 3 Clinical results

^*The same patient who sustained the bilateral tibia plateau fracture, case no. 6 and 7 indicates right and left knee joint respectively.