مقايسه نتايج درمان جراحي و غيرجراحي شكستگيهاي طبق تيبيا همراه با جابجايي

COMPARISON OF SURGICAL AND CONSERVATIVE TREATMENT OF TIBIAL PLATEAU FRACTURES

We evaluated the short-term results of 49 tibial plateau fractures in Shafa Hospital between march 1996 to march I998.Thirty-one patients treated by surgery and 18 treated by conservative (non-surgical) methods. In both group the most common type of fracture was Schatzker type I and the least common were type VI and then type III. The average age was 36.9 years (18-65 years) in surgical group and 46.5years (14-78years) in non-surgical group. Follow up was 15 months in average (6-24 months). The treatment in surgical group was fixation of fracture by surgery and using screws, Buttress plate and external fixator or all of them and in non-surgical group was 4 to 6 weeks long leg cast, then cast brace for knee motion. Partial weight bearing 6 weeks and full weight bearing 12 weeks post treatment commenced. A new scoring system was designed with regard to function, pain, X-rays of final results, and marked from 0 to 100. Overall achieved score in surgical group was 80.5% (excellent and good) and 55.5% in non-surgical group. Three patients had complications in surgical group, one had infected non-union of fracture site and the two others had severe limitation of knee motion: The latter may be due to severity of trauma ofcourse. Limitation of knee motion was the main complication in non-surgical group and we think that it would be due to unnecessary and longer immobilization. There is a meaningful differenc between the results of treatment of two groups; surgical group had much better results. Our results show the same principles, as others do, that the main goals in Plateau Fracture treatment is achieving the well aligned limb, stable and congruent joint. Early and controlled knee motion is the second aim.