Indirect reduction and percutaneous screw fixation of displaced tibial plateau fractures

J Orthop Trauma. 1992;6(3):340-6. doi: 10.1097/00005131-199209000-00012.

Abstract

Indirect reduction and percutaneous screw fixation were attempted in 20 displaced tibial plateau fractures in 20 patients. Closed, indirect reduction was successful in 18 fractures; two others, both Schatzker type II fractures, required open reduction. The 18 fractures were followed for an average of 16.2 months (range, 12-24 months). Of the fractures successfully reduced with indirect techniques, 13 were reduced anatomically (72.2%), and five were considered nonanatomic (27.8%). Four of the five fractures with a nonanatomic reduction were type II fractures. Clinically, there were six excellent (33%), 10 good (56%), and two fair (11%) results. No fracture lost reduction; no patient developed an infection. Indirect techniques could effectively reduce only split fragments. Depressed fragments could not be reduced reliably with either ligamentotaxis or percutaneous elevation with a tamp. There was no correlation between radiographic reduction and clinical outcome. It did not matter whether two, three, or four screws were used to stabilize the fracture.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bone Screws*
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / methods*
  • Humans
  • Male
  • Middle Aged
  • Tibia / surgery*
  • Tibial Fractures / classification
  • Tibial Fractures / surgery*
  • Treatment Outcome