2015 ISAKOS Biennial Congress ePoster #602

Wound Complications Following Double Plating in Treatment of Bicondylar Tibial Plateau Fractures. A Comparison Between Single Midline Incision Versus Two-Incision Techniques

Piero Innocenti, MD, Santiago CHILE
Maximiliano Vega, MD, Santiago CHILE
Alvaro Valenzuela, MD, Viña Del Mar CHILE
Carlos Rojas, MD, Santiago, Region Metropolitana CHILE
Carlos Sandoval, MD, Providencia, Región Metropolitana CHILE
Roberto Abusleme, MD, Santiago, Providencia CHILE
Nicolas Gaggero, MD, Santiago, La reina CHILE
Angello Canales, MD, Santiago CHILE
Rainhold Garcia, MD, Santiago CHILE

Hospital del Trabajador - Universidad de los Andes, Santiago, CHILE

FDA Status Not Applicable

Summary: Single midline incision for treatment of bicondylar tibial plateau fracture has been associated with high wound complication rates. We retrospectively compared wound complications between single midline incisions versus two-incision techniques. A single midline incision had more wound complications compared with two-incision techniques (26.1 vs 5%)

Rate:

Abstract:

Introduction

Tibial plateau fractures had been traditionally treated with single midline incision, but due to high wound complication rates other techniques had become popular.

Purpose

In patients with bicondylar tibial plateau fractures treated with double plate fixation, compare wound complication rates using a single midline incision vs. a two-incision technique.

Materials And Methods

Between September of 2007 and December of 2012, 364 tibial plateau fractures were treated in our center. We included patients classified as Schatzker 5 or 6 and treated with double plate fixation. Those with open fractures and compartment syndrome were excluded.
We recorded type of surgical approach, age, operative time, average time for definite surgical treatment and wound complications (superficial infection, deep infection, skin necrosis and the need of delayed wound closure)
There were eighty-six (86) patients classified as Schatzker 5 or 6 and treated with double plate fixation. Patients were grouped according to type of incision (single midline incision or two-incision techniques)
Single midline incision: Forty-six (46) patients, mean age of 47.83 years; mean operative time 155.35 minutes and 5.74 days between injury and surgery.
Two-incision techniques: Forty patients (40) mean age 46.13 years; mean operative time 130.15 minutes and 4.38 days between injury and surgery.

Results

Twelve patients (26.1%) treated with single incision had wound complications compared with two patients (5%) treated with two-incision techniques (P = 0.008)

Conclusions

In patients with bicondylar tibial plateau fractures treated with double plate fixation, a single midline incision had more wound complications compared with two-incision techniques.