Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 14, 2022; 10(2): 502-510
Published online Jan 14, 2022. doi: 10.12998/wjcc.v10.i2.502
Locking compression plate + T-type steel plate for postoperative weight bearing and functional recovery in complex tibial plateau fractures
Hai-Feng Li, Tao Yu, Xing-Fei Zhu, Hua Wang, Ying-Qi Zhang
Hai-Feng Li, Tao Yu, Xing-Fei Zhu, Ying-Qi Zhang, Department of Orthopaedic Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China
Hua Wang, Department of Orthopaedic Surgery, Zhabei Central Hospital, Shanghai, Shanghai 200070, China
Author contributions: Li HF and Yu T designed this retrospective study, Li HF, Yu T and Zhu XF wrote this paper; Li HF, Yu T, Zhu XF, Wang H and Zhang YQ were responsible for sorting the data.
Institutional review board statement: The study was reviewed and approved by the Tongji Hospital Institutional Review Board.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai-Feng Li, MD, Associate Professor, Department of Orthopaedic Surgery, Tongji Hospital, School of Medicine, Tongji University, No. 389 Xincun Road, Shanghai 200065, China. lihaifeng501@163.com
Received: September 9, 2021
Peer-review started: September 9, 2021
First decision: October 18, 2021
Revised: October 24, 2021
Accepted: December 3, 2021
Article in press: December 3, 2021
Published online: January 14, 2022
Processing time: 124 Days and 18.7 Hours
Abstract
BACKGROUND

Complex tibial plateau fractures can seriously affect quality of life and physical and mental health of patients. The anatomical relationship between the proximal tibial bone and soft tissue is complex, resulting in different types of tibial plateau fractures. Violent trauma can lead to displaced fracture, serious soft tissue injury, and potentially, dislocation of the knee joint. Therefore, tibial plateau fractures are extremely unstable.

AIM

To assess the use of locking compression plate (LCP) + T-type steel plate for postoperative weight bearing and functional recovery of complex tibial plateau fractures.

METHODS

Ninety-seven patients with complex tibial plateau fractures who underwent surgery at our hospital were selected for retrospective study. Forty-nine patients had been treated with LCP + T-type steel plate limited internal fixation (study group), and 48 patients with bilateral ordinary steel plate support (control group). The operation process index, postoperative rehabilitation related index, Rasmussen score of the knee joint, tibial plateau varus angle (TPA), tibial plateau retroversion angle (PA), and surgical complications of the two groups were compared.

RESULTS

The operation time and intraoperative bone graft volume in the study group were lower than those in the control group (P < 0.05). There were no significant differences in surgical bleeding, anterior external incision length, postoperative drainage, hospital stay duration, and fracture healing time between the groups (P > 0.05). There was no significant difference in the TPA and PA angle between the groups immediately and 18 mo after surgery (P > 0.05). At 12 mo after surgery, the Rasmussen scale score was higher in the study group than in the control group (P < 0.05). There was no significant difference in the Rasmussen scale score at 18 mo after surgery, and the radiology score at 12 and 18 mo after surgery, between the two groups (P > 0.05). The postoperative complication rate in the study group (3.77%) was lower than that in the control group (15.09%; P < 0.05).

CONCLUSION

LCP + T-type steel plate internal fixation has advantages in terms of minimizing trauma and enabling early postoperative functional exercise, promoting functional recovery and lower limb weight-bearing, and reducing postoperative complications.

Keywords: Locking compression plate; T-type steel plate; Complexity; Tibial plateau fracture; Functional recovery; Complications

Core Tip: Locking compression plate + T-type steel plate limited internal fixation treatment has the advantage of less trauma and enables early postoperative functional exercise to promote functional recovery and lower limb weight-bearing besides being associated with less postoperative complications.