Clinical Outcomes of Fixation of Depressed Posterolateral Tibial Plateau Fractures Using a Direct Lateral Approach
Introduction Fixation of plateau posterolateral fracture (PLF) is challenging because the fracture site is mostly covered by vital neurovascular structures. We operated on 15 cases of PLF using a direct lateral approach. This study aims to report on clinical results. Material and methods Between 201...
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| Veröffentlicht in: | Indian journal of orthopaedics 2023-03, Vol.57 (3), p.466-471 |
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| container_title | Indian journal of orthopaedics |
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| creator | Noktehsanj, Reza Movahedinia, Mohammad Jousheghan, Saman Shakeri Salehi, Bentolhoda Amini, Keyvan Kamrava, Siavash Sajjadi, Mohammadreza Minator |
| description | Introduction
Fixation of plateau posterolateral fracture (PLF) is challenging because the fracture site is mostly covered by vital neurovascular structures. We operated on 15 cases of PLF using a direct lateral approach. This study aims to report on clinical results.
Material and methods
Between 2017 and 2019, 15 cases of PLFs were fixed with a direct lateral approach and a tricortical autologous bone graft from the iliac crest. A depression of more than 2 mm was indicated for the surgical treatment. Clinical evaluation included Lysholm score, International Knee Documentation Committee Score (IKDC) score, and Tegner activity scale after two years follow-up.
Results
The last follow-up was at 24 months after the operation. The mean postoperative Tegner activity scale did not change significantly compared to before the injury (6.5 (6–7) vs. 7 (6–8,
p
= 0.5)). The postoperative IKDC and Lysholm scores improved significantly compared to before the operation (
p
|
| doi_str_mv | 10.1007/s43465-023-00825-6 |
| format | Article |
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Fixation of plateau posterolateral fracture (PLF) is challenging because the fracture site is mostly covered by vital neurovascular structures. We operated on 15 cases of PLF using a direct lateral approach. This study aims to report on clinical results.
Material and methods
Between 2017 and 2019, 15 cases of PLFs were fixed with a direct lateral approach and a tricortical autologous bone graft from the iliac crest. A depression of more than 2 mm was indicated for the surgical treatment. Clinical evaluation included Lysholm score, International Knee Documentation Committee Score (IKDC) score, and Tegner activity scale after two years follow-up.
Results
The last follow-up was at 24 months after the operation. The mean postoperative Tegner activity scale did not change significantly compared to before the injury (6.5 (6–7) vs. 7 (6–8,
p
= 0.5)). The postoperative IKDC and Lysholm scores improved significantly compared to before the operation (
p
< 0.001). The full range of motion was seen in all patients except one who was manipulated after three months.
Conclusions
Surgical treatment using a direct lateral approach is a safe procedure for PLFs that results in good, short-term clinical and radiologic outcomes without fibular osteotomy or compromising the important neurovascular structures.
Level of evidence
IV.</description><identifier>ISSN: 0019-5413</identifier><identifier>EISSN: 1998-3727</identifier><identifier>DOI: 10.1007/s43465-023-00825-6</identifier><identifier>PMID: 36825273</identifier><language>eng</language><publisher>New Delhi: Springer India</publisher><subject>Conservative Orthopedics ; Medicine ; Medicine & Public Health ; Original Article ; Orthopedics ; Surgical Orthopedics</subject><ispartof>Indian journal of orthopaedics, 2023-03, Vol.57 (3), p.466-471</ispartof><rights>Indian Orthopaedics Association 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>Indian Orthopaedics Association 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c298t-ea28c451b782dff66e862e998374d28c7856febefd9275c775809c2b0d8e8cc73</cites><orcidid>0000-0002-7762-9195 ; 0000-0002-2552-309X ; 0000-0002-6572-8794 ; 0000-0003-2081-7619 ; 0000-0001-9008-4487 ; 0000-0001-7889-8015 ; 0000-0002-6518-0052</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s43465-023-00825-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s43465-023-00825-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36825273$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Noktehsanj, Reza</creatorcontrib><creatorcontrib>Movahedinia, Mohammad</creatorcontrib><creatorcontrib>Jousheghan, Saman Shakeri</creatorcontrib><creatorcontrib>Salehi, Bentolhoda</creatorcontrib><creatorcontrib>Amini, Keyvan</creatorcontrib><creatorcontrib>Kamrava, Siavash</creatorcontrib><creatorcontrib>Sajjadi, Mohammadreza Minator</creatorcontrib><title>Clinical Outcomes of Fixation of Depressed Posterolateral Tibial Plateau Fractures Using a Direct Lateral Approach</title><title>Indian journal of orthopaedics</title><addtitle>JOIO</addtitle><addtitle>Indian J Orthop</addtitle><description>Introduction
Fixation of plateau posterolateral fracture (PLF) is challenging because the fracture site is mostly covered by vital neurovascular structures. We operated on 15 cases of PLF using a direct lateral approach. This study aims to report on clinical results.
Material and methods
Between 2017 and 2019, 15 cases of PLFs were fixed with a direct lateral approach and a tricortical autologous bone graft from the iliac crest. A depression of more than 2 mm was indicated for the surgical treatment. Clinical evaluation included Lysholm score, International Knee Documentation Committee Score (IKDC) score, and Tegner activity scale after two years follow-up.
Results
The last follow-up was at 24 months after the operation. The mean postoperative Tegner activity scale did not change significantly compared to before the injury (6.5 (6–7) vs. 7 (6–8,
p
= 0.5)). The postoperative IKDC and Lysholm scores improved significantly compared to before the operation (
p
< 0.001). The full range of motion was seen in all patients except one who was manipulated after three months.
Conclusions
Surgical treatment using a direct lateral approach is a safe procedure for PLFs that results in good, short-term clinical and radiologic outcomes without fibular osteotomy or compromising the important neurovascular structures.
Level of evidence
IV.</description><subject>Conservative Orthopedics</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Surgical Orthopedics</subject><issn>0019-5413</issn><issn>1998-3727</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kEFOwzAQRS0EoqVwARYoSzYBx05sZ1m1FJAqtYt2bTnOpLhK42InEtyGs3Ay3KawZDOj0bz_R_MRuk3wQ4Ixf_QpTVkWY0JjjAXJYnaGhkmei5hyws_REOMkj7M0oQN05f0W44xwwi7RgLKAE06HqJ3UpjFa1dGia7XdgY9s9f01Mx-qNbY5DlPYO_AeymhpfQvO1irUIFmZwoS2PMyqi2ZO6bYLaLT2ptlEKpoaB7qN5id-vN87q_TbNbqoVO3h5tRHaD17Wk1e4vni-XUynsea5KKNQRGh0ywpuCBlVTEGghEI_1GelmHFRcYqKKAqc8IzzXkmcK5JgUsBQmtOR-i-9w1n3zvwrdwZr6GuVQO285JwgTETIhUBJT2qnfXeQSX3zuyU-5QJloe0ZZ-2DGnLY9qSBdHdyb8rdlD-SX7jDQDtAR9WzQac3NrONeHn_2x_AJxajZY</recordid><startdate>20230301</startdate><enddate>20230301</enddate><creator>Noktehsanj, Reza</creator><creator>Movahedinia, Mohammad</creator><creator>Jousheghan, Saman Shakeri</creator><creator>Salehi, Bentolhoda</creator><creator>Amini, Keyvan</creator><creator>Kamrava, Siavash</creator><creator>Sajjadi, Mohammadreza Minator</creator><general>Springer India</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7762-9195</orcidid><orcidid>https://orcid.org/0000-0002-2552-309X</orcidid><orcidid>https://orcid.org/0000-0002-6572-8794</orcidid><orcidid>https://orcid.org/0000-0003-2081-7619</orcidid><orcidid>https://orcid.org/0000-0001-9008-4487</orcidid><orcidid>https://orcid.org/0000-0001-7889-8015</orcidid><orcidid>https://orcid.org/0000-0002-6518-0052</orcidid></search><sort><creationdate>20230301</creationdate><title>Clinical Outcomes of Fixation of Depressed Posterolateral Tibial Plateau Fractures Using a Direct Lateral Approach</title><author>Noktehsanj, Reza ; Movahedinia, Mohammad ; Jousheghan, Saman Shakeri ; Salehi, Bentolhoda ; Amini, Keyvan ; Kamrava, Siavash ; Sajjadi, Mohammadreza Minator</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c298t-ea28c451b782dff66e862e998374d28c7856febefd9275c775809c2b0d8e8cc73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Conservative Orthopedics</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Surgical Orthopedics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Noktehsanj, Reza</creatorcontrib><creatorcontrib>Movahedinia, Mohammad</creatorcontrib><creatorcontrib>Jousheghan, Saman Shakeri</creatorcontrib><creatorcontrib>Salehi, Bentolhoda</creatorcontrib><creatorcontrib>Amini, Keyvan</creatorcontrib><creatorcontrib>Kamrava, Siavash</creatorcontrib><creatorcontrib>Sajjadi, Mohammadreza Minator</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Indian journal of orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Noktehsanj, Reza</au><au>Movahedinia, Mohammad</au><au>Jousheghan, Saman Shakeri</au><au>Salehi, Bentolhoda</au><au>Amini, Keyvan</au><au>Kamrava, Siavash</au><au>Sajjadi, Mohammadreza Minator</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Outcomes of Fixation of Depressed Posterolateral Tibial Plateau Fractures Using a Direct Lateral Approach</atitle><jtitle>Indian journal of orthopaedics</jtitle><stitle>JOIO</stitle><addtitle>Indian J Orthop</addtitle><date>2023-03-01</date><risdate>2023</risdate><volume>57</volume><issue>3</issue><spage>466</spage><epage>471</epage><pages>466-471</pages><issn>0019-5413</issn><eissn>1998-3727</eissn><abstract>Introduction
Fixation of plateau posterolateral fracture (PLF) is challenging because the fracture site is mostly covered by vital neurovascular structures. We operated on 15 cases of PLF using a direct lateral approach. This study aims to report on clinical results.
Material and methods
Between 2017 and 2019, 15 cases of PLFs were fixed with a direct lateral approach and a tricortical autologous bone graft from the iliac crest. A depression of more than 2 mm was indicated for the surgical treatment. Clinical evaluation included Lysholm score, International Knee Documentation Committee Score (IKDC) score, and Tegner activity scale after two years follow-up.
Results
The last follow-up was at 24 months after the operation. The mean postoperative Tegner activity scale did not change significantly compared to before the injury (6.5 (6–7) vs. 7 (6–8,
p
= 0.5)). The postoperative IKDC and Lysholm scores improved significantly compared to before the operation (
p
< 0.001). The full range of motion was seen in all patients except one who was manipulated after three months.
Conclusions
Surgical treatment using a direct lateral approach is a safe procedure for PLFs that results in good, short-term clinical and radiologic outcomes without fibular osteotomy or compromising the important neurovascular structures.
Level of evidence
IV.</abstract><cop>New Delhi</cop><pub>Springer India</pub><pmid>36825273</pmid><doi>10.1007/s43465-023-00825-6</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-7762-9195</orcidid><orcidid>https://orcid.org/0000-0002-2552-309X</orcidid><orcidid>https://orcid.org/0000-0002-6572-8794</orcidid><orcidid>https://orcid.org/0000-0003-2081-7619</orcidid><orcidid>https://orcid.org/0000-0001-9008-4487</orcidid><orcidid>https://orcid.org/0000-0001-7889-8015</orcidid><orcidid>https://orcid.org/0000-0002-6518-0052</orcidid></addata></record> |
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| title | Clinical Outcomes of Fixation of Depressed Posterolateral Tibial Plateau Fractures Using a Direct Lateral Approach |
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