Abstract
Objective Evaluate complication rates and functional outcomes of fibular neck osteotomy for posterolateral tibial plateau fractures. Design Retrospective case series. Setting University hospital. Patients From January 2013 to October 2014, 11 patients underwent transfibular approach for posterolateral fractures of the tibial plateau and were enrolled in the study. All patients who underwent transfibular approach were invited the return to the hospital for another clinical and imaging evaluation. Intervention Transfibular approach (fibular neck osteotomy) with open reduction and internal fixation for posterolateral fractures of the tibial plateau. Main outcome measurements Complications exclusively related to the transfibular approach: peroneal nerve palsy; knee instability; loss of reduction; nonunion and malunion of fibular osteotomy; and functional outcomes related to knee function. Results Two patients failed to follow-up and were excluded from the study. Of the 9 patients included in the study, no patients demonstrated evidence of a peroneal nerve palsy. One patient presented loss of fracture reduction and fixation of the fibular neck osteotomy, requiring revision screw fixation. There were no malunions of the fibular osteotomy. None of the patients demonstrated clinically detectable posterolateral instability of the knee following surgery. American Knee Society Score was good in 7 patients (77.8%), fair in 1 (11.1%), and poor in 1 (11.1%). American Knee Society Score/Function showed 80 points average (60–100, S.D:11). Conclusion The transfibular approach for posterolateral fractures is safe and useful for visualizing posterolateral articular injury. The surgeon must gently protect the peroneal nerve during the entire procedure and fix the osteotomy with long screws to prevent loss of reduction. Level of evidence Therapeutic level IV.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2320-2325 |
| Number of pages | 6 |
| Journal | Injury |
| Volume | 47 |
| Issue number | 10 |
| DOIs | |
| State | Published - Oct 1 2016 |
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Keywords
- Fibular neck osteotomy
- Fractures
- Fractures of the tibial plateau
- Knee fractures
- Nonunion
- Peroneal nerve palsy
- Plate fixation
- Tibial plateau
- Tibial plateau fractures
- Transfibular osteotomy
ASJC Scopus subject areas
- Emergency Medicine
- Orthopedics and Sports Medicine
Cite this
Complications and outcomes of the transfibular approach for posterolateral fractures of the tibial plateau. / Pires, Robinson Esteves Santos; Giordano, Vincenzo; Wajnsztejn, André; Oliveira Santana, Egidio; Pesantez, Rodrigo; Lee, Mark A; de Andrade, Marco Antônio Percope.
In: Injury, Vol. 47, No. 10, 01.10.2016, p. 2320-2325.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Complications and outcomes of the transfibular approach for posterolateral fractures of the tibial plateau
AU - Pires, Robinson Esteves Santos
AU - Giordano, Vincenzo
AU - Wajnsztejn, André
AU - Oliveira Santana, Egidio
AU - Pesantez, Rodrigo
AU - Lee, Mark A
AU - de Andrade, Marco Antônio Percope
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Objective Evaluate complication rates and functional outcomes of fibular neck osteotomy for posterolateral tibial plateau fractures. Design Retrospective case series. Setting University hospital. Patients From January 2013 to October 2014, 11 patients underwent transfibular approach for posterolateral fractures of the tibial plateau and were enrolled in the study. All patients who underwent transfibular approach were invited the return to the hospital for another clinical and imaging evaluation. Intervention Transfibular approach (fibular neck osteotomy) with open reduction and internal fixation for posterolateral fractures of the tibial plateau. Main outcome measurements Complications exclusively related to the transfibular approach: peroneal nerve palsy; knee instability; loss of reduction; nonunion and malunion of fibular osteotomy; and functional outcomes related to knee function. Results Two patients failed to follow-up and were excluded from the study. Of the 9 patients included in the study, no patients demonstrated evidence of a peroneal nerve palsy. One patient presented loss of fracture reduction and fixation of the fibular neck osteotomy, requiring revision screw fixation. There were no malunions of the fibular osteotomy. None of the patients demonstrated clinically detectable posterolateral instability of the knee following surgery. American Knee Society Score was good in 7 patients (77.8%), fair in 1 (11.1%), and poor in 1 (11.1%). American Knee Society Score/Function showed 80 points average (60–100, S.D:11). Conclusion The transfibular approach for posterolateral fractures is safe and useful for visualizing posterolateral articular injury. The surgeon must gently protect the peroneal nerve during the entire procedure and fix the osteotomy with long screws to prevent loss of reduction. Level of evidence Therapeutic level IV.
AB - Objective Evaluate complication rates and functional outcomes of fibular neck osteotomy for posterolateral tibial plateau fractures. Design Retrospective case series. Setting University hospital. Patients From January 2013 to October 2014, 11 patients underwent transfibular approach for posterolateral fractures of the tibial plateau and were enrolled in the study. All patients who underwent transfibular approach were invited the return to the hospital for another clinical and imaging evaluation. Intervention Transfibular approach (fibular neck osteotomy) with open reduction and internal fixation for posterolateral fractures of the tibial plateau. Main outcome measurements Complications exclusively related to the transfibular approach: peroneal nerve palsy; knee instability; loss of reduction; nonunion and malunion of fibular osteotomy; and functional outcomes related to knee function. Results Two patients failed to follow-up and were excluded from the study. Of the 9 patients included in the study, no patients demonstrated evidence of a peroneal nerve palsy. One patient presented loss of fracture reduction and fixation of the fibular neck osteotomy, requiring revision screw fixation. There were no malunions of the fibular osteotomy. None of the patients demonstrated clinically detectable posterolateral instability of the knee following surgery. American Knee Society Score was good in 7 patients (77.8%), fair in 1 (11.1%), and poor in 1 (11.1%). American Knee Society Score/Function showed 80 points average (60–100, S.D:11). Conclusion The transfibular approach for posterolateral fractures is safe and useful for visualizing posterolateral articular injury. The surgeon must gently protect the peroneal nerve during the entire procedure and fix the osteotomy with long screws to prevent loss of reduction. Level of evidence Therapeutic level IV.
KW - Fibular neck osteotomy
KW - Fractures
KW - Fractures of the tibial plateau
KW - Knee fractures
KW - Nonunion
KW - Peroneal nerve palsy
KW - Plate fixation
KW - Tibial plateau
KW - Tibial plateau fractures
KW - Transfibular osteotomy
UR - http://www.scopus.com/inward/record.url?scp=84995451734&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84995451734&partnerID=8YFLogxK
U2 - 10.1016/j.injury.2016.07.010
DO - 10.1016/j.injury.2016.07.010
M3 - Article
C2 - 27480912
AN - SCOPUS:84995451734
VL - 47
SP - 2320
EP - 2325
JO - Injury
JF - Injury
SN - 0020-1383
IS - 10
ER -