Abstract
Aim : We investigated the combination of closed reduction, percutaneous osteosynthesis with screws and external fixation in the treatment of high-energy fractures of the tibial condyles with severe soft-tissue lesions.
Method : We studied 35 fractures (11 open) of the tibial condyles. Twenty-eight were Schatzker type VI, 5 type V and 2 type I. The fracture was reduced under fluoroscopic control and the articular surface was fixed with cannulated lag screws. In 23 patients (group A) a unilateral external fixation was applied with the proximal pins placed in the tibial condyles. In 12 patients (group B) an external fixation crossing the knee was used for 6 weeks followed by a knee brace. The follow-up period was 8–45 months
Results: All fractures united in a mean time of 15 weeks except for two in group A that needed conversion to internal fixation. Ten knees developed pintract infection. All knees had range of motion of at least 1000 except for one in group B that developed osteoarththritis. A collapse of the articular surface of more than 5mm and malalignment of more than 60 were observed in 7 and 5 patients in group A and B respectively.
Conclusions: Limited internal and external fixation are a satisfactory technique for selected fractures of the tibial plateau, particularly with poor soft-tissue envelope. Crossing the knee with the external fixator does not necessarily lead to significant stiffness.
The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.
