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Wolfgang Lehmann - One of the best experts on this subject based on the ideXlab platform.

  • The degree of articular depression as a predictor of soft-tissue injuries in Tibial Plateau Fracture
    Knee Surgery Sports Traumatology Arthroscopy, 2013
    Co-Authors: Alexander S. Spiro, Marc Regier, Alexander Novo De Oliveira, Eik Vettorazzi, Michael Hoffmann, Jan Philipp Petersen, Frank Oliver Henes, Thomas Demuth, Johannes M. Rueger, Wolfgang Lehmann
    Abstract:

    Purpose Magnetic resonance imaging (MRI) provides sufficient information with regard to specific soft-tissue injuries in the knee, but it is not generally used to evaluate acute Tibial Plateau Fractures. The aim of the present study was to determine whether the amount of Tibial Plateau Fracture depression on multi-detector computed tomography (MDCT) scans correlates with the incidence of associated soft-tissue injuries on MRI. Methods A total of 54 consecutive patients with a mean age of 51.2 years (SD = 18.3) were included in this retrospective study. All patients were admitted to the emergency department of a university clinic with acute Tibial Plateau Fracture. The amount of articular depression was assessed from MDCT scans. Magnetic resonance images were evaluated for crucial and collateral ligament injury, meniscal tears, and patellar retinaculum lesions. Results Logistic regression revealed a significant impact of increasing Tibial Plateau Fracture depression on the incidence of meniscus lateralis tears ( P  = 0.025) and anterior cruciate ligament lesions ( P  = 0.018). Analysis of covariance demonstrated a significant correlation between the amount of articular depression and absolute number of soft-tissue injuries ( P  = 0.001). Conclusions Articular depression is a potential predictor of specific meniscal and ligamentous injuries in acute Tibial Plateau Fracture. Magnetic resonance imaging is generally recommended with respect to associated soft-tissue injuries, especially in cases with distinct Tibial Plateau Fracture depression on multi-detector computed tomography scans. Level of evidence Case series, Level IV.

  • the degree of articular depression as a predictor of soft tissue injuries in Tibial Plateau Fracture
    Knee Surgery Sports Traumatology Arthroscopy, 2013
    Co-Authors: Alexander S. Spiro, Marc Regier, Eik Vettorazzi, Michael Hoffmann, Jan Philipp Petersen, Frank Oliver Henes, Thomas Demuth, Johannes M. Rueger, Alexander Novo De Oliveira, Wolfgang Lehmann
    Abstract:

    Purpose Magnetic resonance imaging (MRI) provides sufficient information with regard to specific soft-tissue injuries in the knee, but it is not generally used to evaluate acute Tibial Plateau Fractures. The aim of the present study was to determine whether the amount of Tibial Plateau Fracture depression on multi-detector computed tomography (MDCT) scans correlates with the incidence of associated soft-tissue injuries on MRI.

Stephen E. James - One of the best experts on this subject based on the ideXlab platform.

Richard Jenkinson - One of the best experts on this subject based on the ideXlab platform.

  • risk of total knee arthroplasty after operatively treated Tibial Plateau Fracture a matched population based cohort study
    Journal of Bone and Joint Surgery American Volume, 2014
    Co-Authors: David Wasserstein, Patrick Henry, Michael J Paterson, Hans J Kreder, Richard Jenkinson
    Abstract:

    Background: The aims of operative treatment of displaced Tibial Plateau Fractures are to stabilize the injured knee to restore optimal function and to minimize the risk of posttraumatic arthritis and the eventual need for total knee arthroplasty. The purpose of our study was to define the rate of subsequent total knee arthroplasty after Tibial Plateau Fractures in a large cohort and to compare that rate with the rate in the general population. Methods: All patients sixteen years of age or older who had undergone surgical treatment of a Tibial Plateau Fracture from 1996 to 2009 in the province of Ontario, Canada, were identified from administrative health databases with use of surgeon fee codes. Each member of the Tibial Plateau Fracture cohort was matched to four individuals from the general population according to age, sex, income, and urban/rural residence. The rates of total knee arthroplasty at two, five, and ten years were compared by using time-to-event analysis. A separate Cox proportional hazards model was used to explore the influence of patient, provider, and surgical factors on the time to total knee arthroplasty. Results: We identified 8426 patients (48.5% female; median age, 48.9 years) who had undergone fixation of a Tibial Plateau Fracture and matched them to 33,698 controls. The two, five, and ten-year rates of total knee arthroplasty in the Plateau Fracture and control cohorts were 0.32% versus 0.29%, 5.3% versus 0.82%, and 7.3% versus 1.8%, respectively (p < 0.0001). After adjustment for comorbidity, Plateau Fracture surgery was found to significantly increase the likelihood of total knee arthroplasty (hazard ratio [HR], 5.29 [95% confidence interval, 4.58, 6.11]; p < 0.0001). Higher rates of total knee arthroplasty were also associated with increasing age (HR, 1.03 [1.03, 1.04] per year over the age of forty-eight; p < 0.0001), bicondylar Fracture (HR, 1.53 [1.26, 1.84]; p < 0.0001), and greater comorbidity (HR, 2.17 [1.70, 2.77]; p < 0.001). Conclusions: Ten years after Tibial Plateau Fracture surgery, 7.3% of the patients had had a total knee arthroplasty. This corresponds to a 5.3 times increase in likelihood compared with a matched group from the general population. Older patients and those with more severe Fractures are also more likely to need total knee arthroplasty after repair of a Tibial Plateau Fracture. Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence. Peer Review This article was reviewed by the Editor-in-Chief and one Deputy Editor, and it underwent blinded review by two or more outside experts. It was also reviewed by an expert in methodology and statistics. The Deputy Editor reviewed each revision of the article, and it underwent a final review by the Editor-in-Chief prior to publication. Final corrections and clarifications occurred during one or more exchanges between the author(s) and copyeditors.

Panayiotis J Papagelopoulos - One of the best experts on this subject based on the ideXlab platform.

  • reconstruction of a neglected Tibial Plateau Fracture malunion with an open book osteotomy a case report
    Journal of Bone and Joint Surgery American Volume, 2017
    Co-Authors: Dimitrios S Mastrokalos, Georgios N Panagopoulos, Dimitrios Koulalis, Konstantinos Soultanis, Vasileios A Kontogeorgakos, Panayiotis J Papagelopoulos
    Abstract:

    Case: Surgical management of Tibial Plateau Fractures can be challenging, and complications can be devastating. We report the case of a lateral Tibial Plateau Fracture malunion with an associated intra-articular depression, which we treated with an open-book osteotomy, obviating the need for an early corrective osteotomy or knee arthroplasty. Conclusion: A Tibial Plateau Fracture malunion can be reconstructed. The surgical team should give priority to salvage options, which can obviate or delay the need for and the implications of an early total knee arthroplasty, especially in a young and active patient.

Bingfang Zeng - One of the best experts on this subject based on the ideXlab platform.

  • anatomical evaluation of the modified posterolateral approach for posterolateral Tibial Plateau Fracture
    European Journal of Orthopaedic Surgery and Traumatology, 2013
    Co-Authors: Hui Sun, Cong-feng Luo, Guang Yang, Huipeng Shi, Bingfang Zeng
    Abstract:

    Objective The study was undertaken to evaluate the efficacy and safety of a posterolateral reversed L-shaped knee joint incision for treating the posterolateral Tibial Plateau Fracture.

  • biomechanical analysis of four different fixations for the posterolateral shearing Tibial Plateau Fracture
    Knee, 2012
    Co-Authors: Wei Zhang, Zhimin Zeng, Sven Putnis, Bingfang Zeng
    Abstract:

    The posterolateral shearing Tibial Plateau Fracture is uncommon in the literature, however with the increased usage of computer tomography (CT), the incidence of these Fractures is no longer as low as previously thought. Few studies have concentrated on this Fracture, least of all using a biomechanical model. The purpose of this study was to compare and analyse the biomechanical characteristics of four different types of internal fixation to stabilise the posterolateral shearing Tibial Plateau Fracture. Forty synthetic tibiae (Synbone, right) simulated the posterolateral shearing Fracture models and these were randomly assigned into four groups; Group A was fixed with two anterolateral lag screws, Group B with an anteromedial Limited Contact Dynamic Compression Plate (LC-DCP), Group C with a lateral locking plate, and Group D with a posterolateral buttress plate. Vertical displacement of the posterolateral fragment was measured using three different strengths of axial loading force, and finally loaded until fixation failure. It was concluded that the posterolateral buttress plate is biomechanically the strongest fixation method for the posterolateral shearing Tibial Plateau Fracture.

  • Rehabilitation of the knee joint function affected by Tibial Plateau Fracture combined with meniscus tear
    Chinese Journal of Orthopaedic Trauma, 2009
    Co-Authors: Jian Ding, Cong-feng Luo, Bingfang Zeng
    Abstract:

    Objective To analyze the effect of meniscus tear on prognosis of Tibial Plateau Fracture and the effect of Fracture on meniscus healing by comparing the outcomes of simple Tibial Plateau Fractures and the Fractures combined with meniscus injury. Methods A retrospective analysis was conducted in 57 cases of Tibial Plateau Fractures treated with internal fixation in our hospital from January 2004 to June 2006. Twenty-three of them were complicated with meniscus tear and received repairing. Knee joint functions were evaluated by the HSS (The Hospital for Special Surgery) score. The menisci were examined by Joint-line tenderness, McMurray, Apley and Thessaly tests. The femoroTibial angle (FTA), Tibial Plateau angle (TPA) and posterior slop angle (PA) were measured on X-ray images. Results Fifty cases were followed up for an average Of 15 (6 to 24) months. The HSS scores for the simple Tibial Plateau Fracture and the Tibial Plateau Fracture combined with meniscus tear were 87.9 and 87.1, respectively. There were no statistical signifi-cances in HSS score(t=0.351, P=0.727), FTA, TPA and PA results between the 2 groups. No more positive physical signs of meniscus tear were found in the group of Tibial Plateau Fracture combined with meniscus tear than in the other group. Conclusions Meniscus tear may not affect the postoperative re-habilitation of the knee joint with Tibial Plateau Fracture; neither is there evidence that Tibial Plateau Fracture may hinder meniscus healing. Key words: Tibia ; Fracture ; Fracture fixation, internal; Menisci, Tibial