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Journal of Orthopaedic Surgery and Research

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Open Access 01-12-2019 | Tibial Plateau Fracture | Research article

Failure analysis of primary surgery and therapeutic strategy of revision surgery for complex tibial plateau fractures

Authors: Zhe Song, Qian Wang, Teng Ma, Chen Wang, Na Yang, Hanzhong Xue, Zhong Li, Yangjun Zhu, Kun Zhang

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2019

Abstract

Purpose

To analyze the cause of failure of the primary surgery for complex tibial plateau fractures and to define the therapeutic strategy of the revision surgery for the same.

Methods

Twenty-one cases with failure of primary surgery for complex tibial plateau fractures were treated in our hospital from January 2012 to September 2016. There were 13 males and 8 females with an average age of 39.4 years (ranged between 27 and 58 years). Patients presented with different types of complex tibial plateau fractures like Schatzker type V (n=9), VI (n=12), type 41.C1 (n=9), type 41.C2 (n=6), and type 41.C3 (n=6). The therapeutic strategy for revision surgery in individual patients was decided following careful analysis and accurate assessment of the causes of failure of the primary surgery. All the patients were followed-up with Rasmussen radiographic scores and Hospital for Special Surgery (HSS) knee scores.

Results

All 21 patients underwent clinical and radiological examination after a mean follow-up time of 32.6 months. The average time of fracture healing was 4.5 months (ranged between 3 and 6 months). During the last follow-up, the mean range of motion of knee extension was 2.3° and knee flexion was 123.8°. The mean radiological Rasmussen score was 15.6 points, with an overall success rate of 85.7%. The average HSS knee score was 84.3 points, with an overall success rate of 80.9%.

Conclusion

The common reasons for the failure of primary surgery of complex tibial plateau fractures were inadequate experience of the surgeon, inaccurate diagnosis and management, improper selection of implants, and poor surgical techniques. The key factors to succeed revision surgery were adequate preoperative evaluation, accurate intraoperative procedures, and proper postoperative rehabilitation.

Level of evidence

Level IV, case series, treatment study

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Title: Failure analysis of primary surgery and therapeutic strategy of revision surgery for complex tibial plateau fractures
Authors: Zhe Song
Qian Wang
Teng Ma
Chen Wang
Na Yang
Hanzhong Xue
Zhong Li
Yangjun Zhu
Kun Zhang
Publication date: 01-12-2019
Publisher: BioMed Central
Keyword: Tibial Plateau Fracture
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2019
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-019-1147-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Failure analysis of primary surgery and therapeutic strategy of revision surgery for complex tibial plateau fractures

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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