Analysis of clinical effect on the tibial plateau fractures by internal fixation

Objective To investigate the fixation methods of tibial plateau fracture and assess their efficacy.Methods Seventy-four cases of tibial plateau fractures treated from January 2003 to December 2008 in our hospital were retrospectively analyzed.All cases were fresh fractures which were treated within two weeks after the trauma.Among them,58 cases were male,16 cases were female.The patient was aged 16~72 years old(average 46.3 years old).30 cases complicated with ligament and the meniscus injury in knee.According to Sehatzker's classification,9 cases were typeⅠ,42 cases were typeⅡ,8 cases were type Ⅲ,5 were type Ⅳ,3 were type V and 7 cases were type Ⅵ.According to the type of fracture,different incision was used for the treatment of open reduction and internal fixation,allograft bone was planted at the same time if the bone damage existed.Results Seventy-two cases were followed up from 3~42 months,with an average of 34 months.All the fractures healed.According to the HSS criteria,the function of the knee joint was rated as excellent in 51 patients,good in 12 and fair in 9.The satisfactory rate was 87.5%.Conclusions Intenal fixation is an effective method to treat tibial plateau fracture,and the operation procedures should be varied with the fracture types.Complications after operation are closely associated with the degree of damage,the timing of surgery and the quality of surgical reduction.Early anatomical reduction,bone transplantation,stable intenal fixation,and early non-weight-bearing functional exercises are important.Soft tissue injury must be evaluated accurately.