Comparison of cannulated lag screws and lateral locking plate in the treatment of Schatzker type II tibial plateau fractures

Objectives: This study aims to compare the clinical and radiological outcomes of the two fixation methods frequently used in the treatment of Schatzker type II fractures: lag screw fixation and lateral anatomic plate fixation. Patients and methods: This retrospective study, which was conducted between January 2005 and December 2014, included 61 patients (41 males, 20 females; mean age 43.4±13.1 years; range, 20 to 76 years) with Schatzker type II (Orthopaedic Trauma Association (OTA)/Arbeitsgemeinschaft für Osteosynthesefragen (AO) 41-B3) fractures. Patients were divided into two groups according to the type of surgery as cannulated lag screw fixation group (group 1, n=24, 39.4%) and lateral locking plate fixation group (group 2, n=37, 60.6%). Intraoperative mediolateral and anteroposterior instability were measured. Final knee flexionextention range of motion (ROM), single-leg hop test, Knee Society Score (KSS), Hospital for Special Surgery (HSS) and short form 36 (SF36) scores were obtained at the last follow-up. Results: The mean age of patients was 42.1±13.8 years in group 2 and 45.5±12.2 years in group 1. The mean follow-up period was 34±4 months. Minimal or no arthritis was detected in 75% (n=18) of patients in group 1 and 78% (n=29) of patients in group 2 (p=0.27). Single leg-hop test results (p=0.55), final follow-up knee ROM (p=0.40), KSS (p=0.21), HSS (p=0.15), and SF36 scores of group 1 were similar to group 2. In group 1, the duration of surgery was shorter (p<0.001) and the cost of treatment was lower (p<0.001). Conclusion: Treatment of Schatzker type II tibial plateau fractures with lag screws seems to provide less invasive, cheaper, and faster surgical treatment as compared with lateral locking plate fixation. In addition, patients who underwent internal fixation with lag screws had similar clinical and radiological outcomes with those who underwent lateral locking plate fixation

A Retrospective Study of Congenital Cardiac Abnormality Associated with Scoliosis

Study DesignRetrospective study.PurposeTo identify the incidence of congenital cardiac abnormalities in patients who had scoliosis and underwent surgical treatment for scoliosis.Overview of LiteratureCongenital and idiopathic scoliosis (IS) are associated with cardiac abnormalities. We sought to establish and compare the incidence of congenital cardiac abnormalities in patients with idiopathic and congenital scoliosis (CS) who underwent surgical treatment for scoliosis.MethodsNinety consecutive scoliosis patients, who underwent surgical correction of scoliosis, were classified as CS (55 patients, 28 female [51%]) and IS (35 patients, 21 female [60%]). The complete data of the patients, including medical records, plain radiograph and transthoracic echocardiography were retrospectively assessed.ResultsWe found that mitral valve prolapse was the most common cardiac abnormality in both patients with IS (nine patients, 26%) and CS (13 patients, 24%). Other congenital cardiac abnormalities were atrial septal aneurysm (23% of IS patients, 18% of CS patients), pulmonary insufficiency (20% of IS patients, 4% of CS patients), aortic insufficiency (17% of IS patients), atrial septal defect (11% of IS patients, 13% of CS patients), patent foramen ovale (15% of CS patients), dextrocardia (4% of CS patients), bicuspid aortic valve (3% of IS patients), aortic stenosis (2% of CS patients), ventricular septal defect (2% of CS patients), and cardiomyopathy (2% of CS patients).ConclusionsWe determined the increased incidence of congenital cardiac abnormalities among patients with congenital and IS. Mitral valve prolapse appeared to be the most prevalent congenital cardiac abnormality in both groups