[Stability, function, alignment and associated injuries after surgical intervention and rehabilitation of tibial plate fracture]

INTRODUCTION

tibial plateau fractures affect functionality of a large load bearing joint such as the knee, due to its multiple compromises, not only articular but also the ones including soft tissues. This study aims to evaluate the stability, function, alignment, associated injuries and complications of the knee after surgery and tibial plateau fractures rehabilitation.

MATERIAL AND METHODS

a descriptive prospective observational study was carried out where patients with a tibial plateau fracture who had undergone surgery, that accomplish the inclusion criteria were included, in the period from April 2018 to June 2019. Analysis of variables was performed with t tests for independent samples.

RESULTS

from a total of 92 patients with tibial plateau fracture, 66 (71%) were able to achieve the minimum six months follow-up. The most common fracture according to Schatzker classification was type II with 33.3%, and the most common according to Luo classification was the medial, lateral and posterior three column with 39.4%. More than 70% of patients who underwent surgery due to tibial plateau fractures developed soft tissue injury, therefore knee instability, specially with a higher rate of anterior cruciate ligament injuries or anterior instability.

CONCLUSION

an important proportion of patients who underwent surgery for tibial plateau fractures have knee ligament injuries.

[No infected union of subtrochanteric fracture of femur, treated with autograft and plate]

Hip fractures are considered a public health problem in the world. Among hip fractures we find subtrochanteric fractures that are defined as proximal femur fractures located in the trochanteric region within 5 cm below the lesser trochanter; and they have an approximate incidence of 15 to 20 per 100,000 people. The objective of this case is to report the success of the reconstruction of an infected subtrochanteric fracture, with a non-vascularized fibular segment and a distal femur condylar support plate. Clinical case: 41-year-old male patient suffering from a right subtrochanteric fracture as a result of a traffic accident that required the use of osteosynthesis material. With subsequent rupture of the cephalomedullary nail in its proximal third, non-union of the fracture and infections at the fracture site. He was treated with multiple surgical lavages, antibiotic therapy, and an unconventional orthopedic and surgical procedure, such as the use of a distal femur condylar support plate and an endomedullary bone graft with a 10-cm segment of non-vascularized fibula. Patient with satisfactory and favorable evolution.