KONG Xiangru , WANG Bing , YANG Chun , SHAN Yuzhou , CHEN Hao , SUN Jianning , JIANG Wei , QIAN Yu , YANG Taiming , LIU Xu
  • Department of Orthopedics, Nanjing Drum Tower Hospital Group Suqian Hospital, the Affiliated Suqian Hospital of Xuzhou Medical University, Suqian Jiangsu, 223800, P. R. China;
LIU Xu, Email: liudongxu@163.com
Tibial plateau fracture; internal fixation; lateral raft plate; jail screw technique
10.7507/1002-1892.202209014
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Objective  To investigate the short-term effectiveness of proximal tibial lateral raft plate combined combined with or without Jail screw fixation in the treatment of tibial plateau collapse fractures involved posterior-lateral column. Methods A retrospective analysis was performed on 106 patients (106 knees) with tibial plateau collapse fracture involved posterior-lateral column admitted between January 2016 and January 2021. According to the combination with Jail screw fixation or not, patients were divided into control group (treated by lateral raft plate without Jail screw fixation, 52 cases) and study group (treated by lateral raft plate with Jail screw fixation, 54 cases). There was no significant difference between the two groups in terms of gender, age, affected knee side, cause of injury, Schatzker classification, Tscherne-Gotzen classification, time from injury to operation, and preoperative lateral tibial plateau posterior slope angle (PSA), tibial plateau varus angle (TPVA), Rasmussen anatomical score (P>0.05). The operation time, cumulative fluoroscopy time, intraoperative blood loss, hospitalization stay, fracture healing time, complications, and lateral tibial plateau PSA, TPVA, Rasmussen anatomical score detected by X-ray films and CT before operation and at 1 year after operation of the two groups were recorded and compared. The number of cases of articular surface collapse in the two groups was recorded at 1 year after operation, and the effectiveness was evaluated by American Special Surgery Hospital (HSS) score. Results All patients were followed up 12-32 months (mean, 19.5 months). There was no significant difference between the two groups in operation time, cumulative fluoroscopy time, intraoperative blood loss, hospitalization stay, and fracture healing time (P>0.05). There were 2 patients (3.7%) in the study group and 3 patients (5.8%) in the control group with superficial wound infection, which were cured after debridement and dressing change. There was no significant difference in the incidence between the two groups (χ2=0.252, P=0.616). There was no complication such as vascular and nerve injury, internal fixation failure, nonunion or malunion of fracture, and deep vein thrombosis of lower limbs in both groups. At 1 year after operation, 9 cases (17.3%) in the control group had joint collapse of 2-3 mm, while only 2 cases (3.7%) in the study group had joint collapse, showing significant difference (χ2=5.271, P=0.022). At 1 year after operation, the PSA, TPVA, and Rasmussen anatomical scores of the two groups were significantly improved when compared with preoperative ones (P<0.05); the differences of pre- and post-operative PSA, TPVA, Rasmussen anatomical score, and postoperative HSS score in the study group were significantly better than those in the control group (P<0.05). Conclusion The lateral raft plate combined with or without Jail screw fixation can achieve satisfactory short-term effectiveness in the treatment of tibial plateau collapse fractures involved posterior-lateral column. Combined with Jail screw, it can enhance the fixation and avoid the occurrence of secondary articular surface collapse, which can be used as a better choice.

Citation： KONG Xiangru, WANG Bing, YANG Chun, SHAN Yuzhou, CHEN Hao, SUN Jianning, JIANG Wei, QIAN Yu, YANG Taiming, LIU Xu. Short-term effectiveness of lateral raft plate combined with Jail screw fixation in treatment of tibial plateau collapse fractures involved posterior-lateral column. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(1): 12-18. doi: 10.7507/1002-1892.202209014 Copy

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