{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T21:35:19Z","timestamp":1772228119706,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,8,12]],"date-time":"2013-08-12T00:00:00Z","timestamp":1376265600000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify the most effective treatment for application to high\u2010energy complex plateau fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>125 patients with closed high\u2010energy complex tibial plateau fractures who had been surgically treated between 2003 and 2010 were reviewed retrospectively. Five procedure methods were studied (e.g. four open reduction and internal fixations, and close reduction via a minimal incision with hybrid external fixation) in five surgical timings, with a control group. The incidence of wound complications after operative treatment in the five surgical timings and the clinical effects of the five surgical procedure options were evaluated statistically. A postoperative follow\u2010up ranging 26\u2013110 months (mean, 36.5 months) was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the various groups, the respective overall wound complication incidences were 20.0%, 41.6%, 33.3%, 2.5%, and 16.7% within 4 hours, 4 hours to 3 days, 3\u20135 days, 5\u20138 days, and more than 8 days after injury. Failed fixation was clearly observed in Group 1 (23.1%, 6\/26) and Group 5 (21.7%, 5\/23) (<jats:italic>P<\/jats:italic> &lt; 0.05). Significant differences were also found among Group 2 (92.6%), Group 3 (93.3%), and Group 5 (69.6%), in terms of the good and excellent rate of joint function according to the Rasmussen score (<jats:italic>P<\/jats:italic> &lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The optimal surgical timing is within 4 hours after trauma, for which no obvious swelling was observed in the limbs. This is followed by surgical timing within 5\u20138 days, after which trauma showed only subsided limb swelling. Dual plating provides the best stabilization option, as it allows early joint mobilization, cartilage regeneration, and joint remodeling, thus decreasing the risk of joint stiffness. Hybrid external fixation may provide relative stability to maintain fracture alignment without the need for massive soft tissue dissection, and also minimizes blood loss and potential soft tissue complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12057","type":"journal-article","created":{"date-parts":[[2013,8,12]],"date-time":"2013-08-12T11:11:28Z","timestamp":1376305888000},"page":"188-195","source":"Crossref","is-referenced-by-count":27,"title":["An Efficacy Analysis of Surgical Timing and Procedures for High\u2010Energy Complex Tibial Plateau Fractures"],"prefix":"10.1111","volume":"5","author":[{"given":"Yun\u2010qin","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery the 98th Hospital of PLA  Huzhou Zhejiang Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery the 98th Hospital of PLA  Huzhou Zhejiang Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tu\u2010gang","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery the 98th Hospital of PLA  Huzhou Zhejiang Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei\u2010hua","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Radiology the 98th Hospital of PLA  Huzhou Zhejiang Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya\u2010zhong","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery the 98th Hospital of PLA  Huzhou Zhejiang Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,8,12]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"94","article-title":"The tibial plateau fracture. 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