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European Journal of Trauma and Emergency Surgery

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Open Access 14-05-2022 | Osteoarthrosis | Original Article

Two-level fixation with headless compression screws for tibial plateau fractures

Authors: Robert Kaspar Wagner, Peter Kloen

Published in: European Journal of Trauma and Emergency Surgery | Issue 6/2022

Abstract

Purpose

Reduction and fixation of tibial plateau fractures associated with small, “floating” intra-articular fragments proposes a challenge. We use fully threaded headless compression screws for (interfragmentary) fixation of such fragments before final plate fixation when standard fixation of intra-articular fragments with k-wires or lag screws is deemed insufficient. Our aim is to describe our technique and clinical experience of this two-level fixation.

Methods

Between 2006 and 2021, 29 patients with a comminuted tibial plateau fracture were treated with this two-level fixation in this retrospective case series. Clinical baseline and surgical variables were collected for all patients. Clinical outcome variables were available for 28 patients with a median follow-up of 16.5 months (IQR 5–24). Functional outcomes were measured with the Knee Injury and Osteoarthritis Outcome Score (KOOS) and reported by 22 patients at a median of 5.2 years (IQR 3.5–9.8).

Results

Reduction was anatomic or good in 82% of cases, fair in 14%, and a malreduction in 4%. Arthrosis was graded as grade 0 in 25% of cases, 1 in 39%, 2 in 21%, and 3 in 14%. Flexion was 110 degrees (IQR 100–130). Five patients had an extension deficit of 5 to 10 degrees. Median KOOS for symptoms and stiffness was 69 points (IQR 45–78), for pain 71 (IQR 45–88), for ADL 85 (IQR 52–95), for sports 30 (IQR 11–55), and for quality of life 34 (IQR 19–56).

Conclusion

The use of fully threaded headless compression screws is a simple and helpful addition in the treatment of comminuted tibial plateau fractures.

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Title: Two-level fixation with headless compression screws for tibial plateau fractures
Authors: Robert Kaspar Wagner
Peter Kloen
Publication date: 14-05-2022
Publisher: Springer Berlin Heidelberg
Keywords: Osteoarthrosis
Osteoarthrosis
Tibial Plateau Fracture
Published in: European Journal of Trauma and Emergency Surgery / Issue 6/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-022-01982-3

At a glance: The STEP trials

Springer Medicine

Two-level fixation with headless compression screws for tibial plateau fractures

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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