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TIBIAL PLATEAU FRACTURES: A COMPARISON STUDY OF RESULT OF CLOSED REDUCTION AND PERCUTANEOUS CANNULATED SCREW FIXATION VERSUS OPEN REDUCTION AND INTERNAL FIXATION
Bahaa Najm*, Maan Saad and Safwan Yousef
Objective: The aim of this study is to evaluate the functional results of surgical treatments of tibial plateau fractures by either closed reduction with percutaneous cannulated screw fixation or open reduction and internal fixation. In addition to, detection complications resulting from the surgery. Patients and Methods: Retrospective comparative study conducted for the period one year (July 2019 – July 2020) at Tishreen University Hospital in Lattakia-Syria. The study included two groups of patients were compared: group1 consisted of 15 patients (45.5%) who underwent to closed reduction and fixation with percutaneous cannulated screw, whereas group 2 consisted of 18 patients (54.5%) who underwent to open reduction and internal fixation. Results: The median age was 46 years; the most frequent age group was 18-35 year (39%), followed by the group 36-55 year (33%). Males represented 57.5 % of the patients, and right side was affected in 22 patients (67%). High-energy injury was present in 24 patients (73%), and motor vehicle accidents was the most frequent cause of injury (60%). According to Knee Society Scoring system (KSS) during follow up periods, a significant improvement in functional outcome with the same grade was observed in the two groups (p: 0.0002), and 76% of the patients had satisfactory results, more frequently in group 1. Age was significantly associated with excellent and good functional outcomes(p:0.04). The observed complications in group1 were impaired mineralization (6.5%) and stiffness of knee joint (6.5%), whereas stiffness of knee joint (9%) was the most frequent complication in group2. Conclusion: Functional outcome in young patients was better after management of fractures in the form of closed reduction and fixation with percutaneous cannulated screw, whereas in elderly patients better outcome was obtained in open reduction with internal fixation.[Full Text Article]