Closed Reduction and Percutaneous Screw Fixation for Tibial Plateau Fractures

Abstract

Purpose. To evaluate treatment outcomes of closed reduction and percutaneous screw fixation for tibial plateau fractures. Methods. 48 men and 8 women aged 19 to 61 (mean, 36) years underwent closed reduction and percutaneous screw fixation for closed tibial plateau fractures with 10 as poor. Results. Patients were followed up for a mean of 2.8 (range, 1–4) years. The mean length of hospital stay was 5 (range, 2–15) days. All the fracture united radiographically after a mean of 3 (range, 2.5–4.2) months. Respectively in Schatzker types-I, -II, -IV, and -V fractures, outcomes were excellent in 6, 10, 2, and 2 patients, good in 2, 9, 3, and 14 patients, fair in 1, 3, 0, and 2 patients, and poor in 0, 0, 0, and 2 patients. Outcome was satisfactory (good-to-excellent) in 89%, 86%, 100%, and 80% of the respective fracture types of patients. The mean Rasmussen score was 25.7 for all patients; it was 27.7 for type I, 26.3 for type II, 28.6 for type IV, and 23.4 for type V fractures. The mean Rasmussen score was significantly lower in 12 patients with ligament injury than in 44 patients without ligament injury (19.8 vs. 27.3, p<0.001). No patient had any complication (infection, wound dehiscence or hardware problem). Conclusion. Closed reduction and percutaneous screw fixation for tibial plateau fractures is minimally invasive. It reduces the length of hospital stay and costs, enables early mobilisation with minimal instrumentation, and achieves satisfactory outcomes.