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. 2009 Jun;33(3):779-84.
doi: 10.1007/s00264-008-0526-y. Epub 2008 Mar 27.

Bovine cancellous xenograft in the treatment of tibial plateau fractures in elderly patients

M R Bansal  1 , S B Bhagat, D D Shukla
Affiliations

Bovine cancellous xenograft in the treatment of tibial plateau fractures in elderly patients

M R Bansal et al. Int Orthop. 2009 Jun.

Abstract
in English, Spanish

The objective was to evaluate the efficacy of xenografts to improve the outcomes in elderly patients with tibial plateau fractures. Nineteen cases with a mean age of 74 years were followed prospectively from 1998 to 2003. Six patients each belonged to Schatzker types III, IV and V and one patient belonged to type II. Open reduction with fixation and xenograft impaction was carried out. Clinical and radiological union was assessed including infection rate, incorporation of the xenograft and average collapse of the fracture. The average union time was 20 weeks. No patient had wound infection and all had excellent incorporation of the xenograft with union. The average collapse was 4 mm on follow-up. This series shows the use of only an xenograft in acute fixation of these fractures with favourable outcome. Furthermore, it reduces operative time, bleeding and associated co-morbidities, which is of more significance in an elderly age group.

évaluer l’efficacité des xénogreffes chez les patients âgés dans le cadre des fractures du plateau tibial. 19 cas, d’âge moyen de 74 ans ont été suivis et traités de façon prospective de 1998 à 2003. 6 patients présentaient des fractures de type Schatzker III, IV, V et 1 patient présentait une fracture de type II. Le traitement chirurgical a consisté en une réduction par voie sanglante avec fixation et utilisation d’une xénogreffe impactée. L’évaluation a été clinique et radiologique avec notamment, évaluation du taux d’infection et du taux d’incorporation de la xénogreffe ainsi que du pourcentage du collapsus fracturaire. le temps moyen de consolidation a été de 20 semaines. Aucun patient ne présentait d’infections profondes. Tous ont eu une excellente incorporation de la xénogreffe. Le pourcentage moyen de tassement a été de 4 mm. En conclusion cette série montre que l’on peut utiliser des xénogreffes dans le traitement de ces fractures avec une bonne évolution. Ce traitement permet de diminuer le temps opératoire, le saignement et les comorbidités qui sont particulièrement significatives chez les patients âgés.

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Figures

Fig. 1
Fig. 1
a, b Schatzker type V fracture in patient A
Fig. 2
Fig. 2
a, b Patient A at final follow-up
Fig. 3
Fig. 3
a, b Schatzker type III fracture treated with open reduction and cannulated screw fixation in patient B
Fig. 4
Fig. 4
a, b Elevation with bone grafting with xenograft for Schatzker type II fracture
See this image and copyright information in PMC

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