Authors : B. Kienast , A. Paech , C. Queitsch , U. Schumann , R. Oheim , Ch. Jurgens and A.P. Schulz
Abstract: Between January 2003 and January 2005 we treated 26 patients suffering from fractures of the tibial head with an angular stable (or locked) implant. In 15 cases we treated high energy fractures of the Schatzker type V and VI (AO C-type). 11 Patients showed lateral tibial head fractures (AO B-type) with a high degree of osteoporosis. All fractures were treated with a unilateral approach with a lateral locked-plate osteosynthesis. No postoperative wound infection occurred. The average follow-up period was 19.4 months (15-26 months). In 9 cases there was full range of movement (ROM) compared to the not injured side. In 13 cases there was a mild restriction of ROM and in 4 cases restriction of ROM was severe. The Rasmussen Score was good or excellent in 17 cases, the result was fair in 6 and poor in 3 cases. There was no significant loss of reduction caused by implant-failure on follow-up X-rays. For high energy fractures less invasive approach with a high degree of stability of the internal fixation showed a clear advantage concerning postoperative infection rate. In the treatment of osteoporotic bone the use of angular stable implants can prevent implant failure and secondary loss of reduction.
B. Kienast , A. Paech , C. Queitsch , U. Schumann , R. Oheim , Ch. Jurgens and A.P. Schulz , 2008. Tibial Head Fractures-Is There an Advantage in Angular Stable Implants?. Surgery Journal, 3: 69-73.