Effective Kirschner wire fixation for tissue necrosis of open comminuted tibial plateau fracture: A case report and literature review

AbstractBackground:As a part of the knee joint, the tibial plateau plays a very important role in the weight-bearing function of the knee joint. Tibial plateau fracture is usually caused by severe violent injury. Clinical treatment is mainly to reconstruct the structure of tibial plateau and restore the function of knee joint. The main surgical treatments include traditional open reduction and internal fixation, external fixation, and arthroscopy-assisted minimally invasive techniques, depending on the extent of the tibial plateau fracture and the tissue condition of the wound. For patients with open comminuted tibial plateau fracture with poor tissue condition and not suitable for internal and external fixation, the fixation of Kirschner wires can be used as an option for temporary reconstruction of the tibial plateau structure, which is conducive to the early functional exercise of patients, and is an alternative solution.Case presentation:We present the case of a 72-year-old female patient with an open comminuted tibial plateau fracture who sufferd a severe violent traffic accident injury with tissue necrosis around the wound. We performed autologous skin flap to transplant necrotic skin and used Kirschner wires to temporarily fix the tibial plateau. One year postoperatively, the patient's knee function recovered well without traumatic osteoarthritis.Conclusion：Temporary fixation of the Kirschner wires combined with autologous flap transplantation can provide effective support and restore necrotic skin function for open comminuted fractures with poor wound tissue condition that is not suitable for internal and external fixation therapy.