1) To introduce a computed tomography-based "three-column fixation" concept; and 2) to evaluate clinical outcomes (by using a column-specific fixation technique) for complex tibial plateau fractures (Schatzker classification Types V and VI).
Design: Prospective cohort study.
Setting: Level 1 trauma center.
Patients: 29 cases of complex tibial plateau fractures were included. Based on routine x-ray and computed tomography images, all the fractures were classified as a "3-column fracture," which means at least one separate fragment was found in lateral, medial, and posterior columns in the proximal tibia (Schatzker classification Types V and VI).
Intervention: The patients were operated on in a "floating position" with a combined approach, an inverted L-shaped posterior approach combined with an anterior-lateral approach. All three columns of fractures were fixed.
Outcome Measures: Operative time, blood loss, quality of reduction and alignment, fracture healing, complications, and functional outcomes based on Hospital for Special Surgery score and lower-extremity measure were recorded.
Three-column fixation is a new fixation concept in treating complex tibial plateau fractures, which is especially useful for multiplanar fractures involving the posterior column. The combination of posterior and anterior-lateral approaches is a safe and effective way to have direct reduction and satisfactory fixation for such difficult tibial plateau fractures.
Copyright remains with the authors and publisher.
1) To introduce a computed tomography-based "three-column fixation" concept; and 2) to evaluate clinical outcomes (by using a column-specific fixation technique) for complex tibial plateau fractures (Schatzker classification Types V and VI).
Design: Prospective cohort study.
Setting: Level 1 trauma center.
Patients: 29 cases of complex tibial plateau fractures were included. Based on routine x-ray and computed tomography images, all the fractures were classified as a "3-column fracture," which means at least one separate fragment was found in lateral, medial, and posterior columns in the proximal tibia (Schatzker classification Types V and VI).
Intervention: The patients were operated on in a "floating position" with a combined approach, an inverted L-shaped posterior approach combined with an anterior-lateral approach. All three columns of fractures were fixed.
Outcome Measures: Operative time, blood loss, quality of reduction and alignment, fracture healing, complications, and functional outcomes based on Hospital for Special Surgery score and lower-extremity measure were recorded.
Three-column fixation is a new fixation concept in treating complex tibial plateau fractures, which is especially useful for multiplanar fractures involving the posterior column. The combination of posterior and anterior-lateral approaches is a safe and effective way to have direct reduction and satisfactory fixation for such difficult tibial plateau fractures.
Copyright remains with the authors and publisher.