Experience in the Treatment of Complex Hvperextension Tibial Plateau Fracture with Kirschner Needle Prving Reduction
Objective:To investigate the clinical effect of K-wire prying reduction in the treatment of complex hyperextension tibial plateau fractures with posterior cortical injury.Methods:From January 2016 to June 2021,13 patients with complex hyperextension tibial plateau fractures operationed in the Department of Orthopedics,Qidong Hospital of Traditional Chinese Medicine were selected as study subjects.The double condyle and the posterior cortex was broken in all the patients,and all patients were fixed by medial and lateral incision,K-wire prying reduction,double or triple plates,and repaired the combined soft tissue injury.The fracture healing and reduction were evaluated by X-ray.At the last follow-up,the Rasmussen radiological score was used to evaluate the tibial plateau fracture reduction,and the hospital for special surgery(HSS)score was used to evaluate the knee joint function.Results:All 13 cases were operationed successfully,and the operation time was 120～200 minutes,with an average of 148 minutes.The intraoperative blood loss was 250～400 mL,and the average intraoperative blood loss was 300 mL.All 13 cases were followed up for 12～18 months,with an average of 15.6 months.All patients achieved bony union,and the clinical healing time was 8～18 weeks,with an average of 14.3 weeks.The score of Rasmussen radiation 12 months after operation was 14～18.The average score was(15.32±0.51).There was no joint pain and unstable knee joint at the last follow-up,and the knee joint activity reached 0°～135° 12 months after surgery,HSS knee function scores ranged from 83 to 97,with an average of(92.38±1.32)points.Conclusion:The retroversion angle of complex hyperextension tibial plateau fractures changes significantly or even anteverts.The K-wire prying reduction technique is simple to apply,which is beneficial to the recovery of the posterior tilt angle of the tibial plateau.
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