Morphological characteristics and treatment strategy of Schatzker type Ⅱ deep collapse fractures of tibial plateau
Objective To research the morphological characteristics,treatment strategy and clinical effect of Schatzker type Ⅱdeep collapse tibial plateau fractures.Methods A retrospective analysis was conducted on 45 cases of Schatzker type Ⅱ deep collapse tibial plateau fractures treated with open reduction and internal fixation surgery from January 2016 to December 2020.The morphological characteristics of these fractures were collected,and the postoperative clinical efficacy and treatment strate-gies were evaluated.The tibial plateau angle and posterior slope angle of the tibial plateau immediately after surgery and 12 months after surgery were measured to evaluate the loss of fracture reduction.The Rasmussen radiological score was used to evaluate the fracture reduction of tibial plateau.At the last follow-up,the improved HSS score was used to evaluate knee joint function.Results All cases were followed up for 12-22 months,with an average of 16.5 months.During the follow-up period,there was no looseness or breakage of the internal fixation,and no loss of joint surface height.All fractures achieved bone heal-ing in 11-18 weeks,with an average of 13.8 weeks.Twelve months after surgery,the Rasmussen radiological score for tibial pla-teau fracture reduction was 14-18 points,with an average of 16.5 points.Of the 45 cases,36 cases were excellent and 9 cases were good.The improved HSS score for knee joint function 12 months after operation was 80-98 points,with an average score of 92.2 points,while 33 cases were excellent and 12 cases were good.The tibial plateau angle of tibial plateau immediately after surgery was 85.2°-89.2°,with an average of 87.2°;the posterior slope angle of the tibial plateau was 5.6°-8.9°,with an average of 7.1°.The tibial plateau angle of tibial plateau 12 months after surgery was 85.0°-89.2°,with an average of 87.1°;the posteri-or slope angle of the tibial plateau was 5.4°-9.0°,with an average of 7.1°.Conclusion Most of Schatzker type Ⅱ deep col-lapse tibial plateau fractures involve the lateral and posterior columns,which require reduction and fixation of the fractures through anterior lateral or posterior lateral approaches and autologous iliac bone structural grafting to restore joint flatness and lower limb alignment.At the same time,meniscus and ligament injuries should be repaired to reconstruct knee joint stability.
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