Weight-bearing-induced displacement and migration over time of fracture fragments following split depression fractures of the lateral tibial plateau: a case series with radiostereometric analysis

J Bone Joint Surg Br. 2011 Jun;93(6):817-23. doi: 10.1302/0301-620X.93B6.26122.

Abstract

We investigated the stability of seven Schatzker type II fractures of the lateral tibial plateau treated by subchondral screws and a buttress plate followed by immediate partial weight-bearing. In order to assess the stability of the fracture, weight-bearing inducible displacements of the fracture fragments and their migration over a one-year period were measured by differentially loaded radiostereometric analysis and standard radiostereometric analysis, respectively. The mean inducible craniocaudal fracture fragment displacements measured -0.30 mm (-0.73 to 0.02) at two weeks and 0.00 mm (-0.12 to 0.15) at 52 weeks. All inducible displacements were elastic in nature under all loads at each examination during follow-up. At one year, the mean craniocaudal migration of the fracture fragments was -0.34 mm (-1.64 to 1.51). Using radiostereometric methods, this case series has shown that in the Schatzker type II fractures investigated, internal fixation with subchondral screws and a buttress plate provided adequate stability to allow immediate post-operative partial weight-bearing, without harmful consequences.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bone Plates
  • Bone Screws
  • Female
  • Fracture Fixation, Internal / instrumentation
  • Fracture Fixation, Internal / methods*
  • Fracture Fixation, Internal / rehabilitation
  • Humans
  • Male
  • Middle Aged
  • Rotation
  • Tibial Fractures / diagnostic imaging
  • Tibial Fractures / physiopathology
  • Tibial Fractures / rehabilitation
  • Tibial Fractures / surgery*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Weight-Bearing*