ArticleJournal of orthopaedic surgery and research2019
Failure analysis of primary surgery and therapeutic strategy of revision surgery for complex tibial plateau fractures.
Article in Journal of orthopaedic surgery and research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed.
- Association between articular surface depression and functional outcomes after ORIF of tibial plateau fractures: a retrospective cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Stress Distribution in Interlocking and Blocking Screw Fixation for Distal Tibial Intramedullary Nailing: A Finite Element Analysis.Journal of clinical medicine · 2025Article
- Breaking the treatment dilemma of Schatzker IV fractures: finite element analysis validates hybrid single-plate with tension screw fixation for synergistic optimization of stability and minimally invasive outcomes.Frontiers in bioengineering and biotechnology · 2025Article
- The concept of direct approach to lateral tibial plateau fractures and stepwise extension as needed.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2020Review
- Comparison of the effectiveness and safety of intravenous and topical regimens of tranexamic acid in complex tibial plateau fracture: a retrospective study.BMC musculoskeletal disorders · 2020Article
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9 authors.
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Abstract
purposeTo analyze the cause of failure of the primary surgery for complex tibial plateau fractures and to define the therapeutic strategy of the revision surgery for the same.
methodsTwenty-one cases with failure of primary surgery for complex tibial plateau fractures were treated in our hospital from January 2012 to September 2016. There were 13 males and 8 females with an average age of 39.4 years (ranged between 27 and 58 years). Patients presented with different types of complex tibial plateau fractures like Schatzker type V (n=9), VI (n=12), type 41.C1 (n=9), type 41.C2 (n=6), and type 41.C3 (n=6). The therapeutic strategy for revision surgery in individual patients was decided following careful analysis and accurate assessment of the causes of failure of the primary surgery. All the patients were followed-up with Rasmussen radiographic scores and Hospital for Special Surgery (HSS) knee scores.
resultsAll 21 patients underwent clinical and radiological examination after a mean follow-up time of 32.6 months. The average time of fracture healing was 4.5 months (ranged between 3 and 6 months). During the last follow-up, the mean range of motion of knee extension was 2.3° and knee flexion was 123.8°. The mean radiological Rasmussen score was 15.6 points, with an overall success rate of 85.7%. The average HSS knee score was 84.3 points, with an overall success rate of 80.9%.
conclusionThe common reasons for the failure of primary surgery of complex tibial plateau fractures were inadequate experience of the surgeon, inaccurate diagnosis and management, improper selection of implants, and poor surgical techniques. The key factors to succeed revision surgery were adequate preoperative evaluation, accurate intraoperative procedures, and proper postoperative rehabilitation. LEVEL OF EVIDENCE: Level IV, case series, treatment study.
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