Surgical Treatment and Clinical Analysis of 48 Cases of Tibial Plateau Fracture

Objective To investigate the best operation opportunity,operation methods and the effect of treatment on tibial plateau fracture.Methods From January 2003 to January 2006,48 cases with tibial plateau fracture including 11 cases of Schatzker type Ⅳ,20 of typeⅤ and 17 of type Ⅵ were measured with X-ray,CT scan and MRI scan before operation.All cases were treated with open reduction,internal fixation with buttress plates or autologous bone graft and continuous passive motion(CPM) function rehabilitation after operation.Results All cases were followed up form 6 to 36 months,with an average period of 22.8 months.No nonunion or malunion were found in all cases.The mean time for bone union was 16.6 weeks.The flexion of the knee achieved form 110°-135° except 1 case knee enstrophe.The knee function was excellent in 27 cases,good in 16 cases and fair in 5 cases,with the excellent and good rate was 89.6% according to the Rasmussen evaluation system.Conclusion In treatment of tibial plateau fracture,direct open reduction,stable internal fixation with inboard and outboard buttress plates or abundant autologous bone graft in bone defects,minimal invasion to the blood supply of fracture segments,a good protection of the knee joint structure,and early function rehabilitation would ameliorate curative effect and reduce syndrome significant.