Article
Comprehensive evaluation and treatment strategy of tibia plateau fracture with knee dislocation
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Published: | October 22, 2019 |
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Objectives: To achieve the best functional outcome possible with a minimum of complications,it is important to develop a treatment algorithm or protocol. Our article involves a high index of the discussion for the comprehensive evaluation, surgical treatment and clinical efficacy of tibia plateau fracture with knee dislocation.
Methods: 41 cases of tibia plateau fractures with knee dislocation were treated in our department between June 2012 and June 2016. There were 26 males and 15 females with an average age of 43.6(19-65) years-old. Comprehensive preoperative imaging examinations (X-ray films and CT scan), and carefully and accurate assessment for the state of blood vessels, nerves, fracture and ligament were taken for all patients. Lateral and medial combined approach is adopted for the rigid internal fixation of fracture and ligament repairment after the anatomical reduction of fractures and dislocations. All the patients were followed with the time of fracture healing, Rasmussen radiographic scores and HSS knee functional scores.
Results: 41 cases were followed for an average of 14.8 months (12 to24 months). All fractures healed for a mean time of 11.6 weeks(10 to 14 weeks. Rasmussen radiographic scores at 12 months after surgery: excellent in 29 cases, good in 7 cases, fair in 3 cases, poor in 2 cases. HSS knee functional scores at last follow-up: excellent in 27 cases, good in 8 cases, fair in 3 cases, poor 3 cases, good rate:85.4%.
Conclusion: Tibia plateau fractures with knee dislocation should be attached importance to the comprehensive evaluation of the fractures, ligaments around the knee joint, blood vessels, nerves and local soft tissues, prevent the osteofascial compartment syndrome, the misdiagnosis and misdiagnosis of the injuries of blood vessels and nerves, perform the anatomical reduction and rigid internal fixation of fractures after definitive diagnosis and recovery of soft tissues, and give the consideration to the recovery and reconstruction of the dislocation of knee joint at the same time, to ensure that the early functional exercise of knee joint and obtain the satisfied clinical efficacy.