Effect of surgery for malunion of old fractures of tibial plateau with instability

Abstract

Objective: To explore the curative effect of surgery for malunion of tibial plateau fractures and old fractures of tibial plateau.Methods: Fifty-two patients(31 males,21 females) were reviewed and analyzed from May 2004 to March 2009 in our hospital.The average time from fracture or first operation to the treatment was 2.9 months(range,5 weeks to 12 months).Forty-seven patients were treated with open osteotomy,reduction,bonegrafting and internal fixation.Five patients with full-thickness osteochondral defects were treated with open osteotomy,reduction,autologous mosaicplasty osteochondral transplantation and internal fixation.Results: The average follow-up time was 64.2 months.All fractures healed up.All knees demonstrated full extension,but the range of flexion decreased(13.2±2.8) ° in average compared to the opposite side.The Merchant score was excellent in 31 patients,good in 16 and fair in 5.Good rate was 90.4%.Conclusions: Successful therapy can be guaranteed by the following factors: routine X-ray,CT and MRI examinations before operation,anatomical reduction of articular surface,bone graft after reduction,forceful internal fixation and early functional exercises.

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