Comparison of anterior midline incision and double incision in the surgical treatment of tibial plateau fractures

Authors : Ömer BOZDUMAN

Pages : 347-352

Doi:10.32322/jhsm.1218765

View : 13 | Download : 5

Publication Date : 2023-03-27

Article Type : Research Paper

Abstract :Aim: Tibial plateau fractures are complex fractures that often develop after high-energy trauma, often involving intra-articular fractures. They are rarely treated conservatively. Surgical planning and approach are very important in preventing possible complications. In this study, we compared two different incisions in the same fracture types. Material and Method: A total of 26 patients insert ignore into journalissuearticles values(20 males-6 females); with tibial plateau fractures were included in the study. Twelve of the patients were selected from those using anterior midline incisions, and 14 from those using double incisions as anterolateral and posteromedial incisions. The mean age of the patients is 50.8 insert ignore into journalissuearticles values(24-76); years. The distribution of patients according to fracture classification was 9 Schatzker type-6, 17 Schatzker type-5. Average follow-up time is 34.1 months insert ignore into journalissuearticles values(24.5-42.2);. Postoperative complications, union time, joint range of motion, radiological Rasmussen criteria, Medial Proximal Tibial Angle insert ignore into journalissuearticles values(MPTA); and Posterior Proximal Tibial Angle insert ignore into journalissuearticles values(PPTA); measurements, Lachman and valgus-varus stress tests for ligament stability evaluation, Hospital for Special Surgery insert ignore into journalissuearticles values(HSS); and visual analogue scale insert ignore into journalissuearticles values(VAS); assessments were performed to evaluate the clinical status of the patients. Results were compared between both incision groups. Results: Union in the anterior midline was 11.07 insert ignore into journalissuearticles values(±1.68); weeks and bilateral union was 9.96 insert ignore into journalissuearticles values(±1.35); weeks insert ignore into journalissuearticles values(p :0.074);. Rasmussen scoring was 14.83 insert ignore into journalissuearticles values(±2.16); in the anterior group and 14.57 insert ignore into journalissuearticles values(±2.13); in the bilateral group insert ignore into journalissuearticles values(p:0.760);. The MPTA was 85.35 insert ignore into journalissuearticles values(±3.97); degrees in the anterior group, and the MPTA was 86.40 insert ignore into journalissuearticles values(±3.74); degrees in the bilateral group insert ignore into journalissuearticles values(p: 0.492);. PPTA was 80.77 insert ignore into journalissuearticles values(±1.95); degree in the anterior group, and PPTA was 80.85 insert ignore into journalissuearticles values(±1.78); degree in the bilateral group. HSS score was 70 insert ignore into journalissuearticles values(±9.02); in the anterior group and HSS score was 71.71 insert ignore into journalissuearticles values(±1.15); in the bilateral group insert ignore into journalissuearticles values(p:0.681);. Rom was measured as 101.67 insert ignore into journalissuearticles values(±12.67); degrees in the anterior group and 107.86 insert ignore into journalissuearticles values(±13.54); degrees in the bilateral group insert ignore into journalissuearticles values(p: 0.243);. The VAS anterior group was 2.83 insert ignore into journalissuearticles values(±1.64); and the VAS bilateral group was 3.36 insert ignore into journalissuearticles values(±2.09); insert ignore into journalissuearticles values(p:0.491);.Instability was seen in 1 patient in the anterior group and 1 patient in the bilateral group insert ignore into journalissuearticles values(p:1);. Infection was observed in 1 patient in the anterior group and in 3 patients in the bilateral group insert ignore into journalissuearticles values(p:0.598);. Conclusion: The anterior incision is as effective a surgical approach as bilateral incision in correct patient preferences. Surgical site visibility in anterior incision is satisfactory. The principal aspect is to perform the correct surgical planning for the correct patient.
Keywords : tibial plateau fracture, anterior Midline Incision, visual analogue scale