Amaç: Bu çalýþmanýn temel amacý, tibia plato kýrýklarýnýn tedavisinde 5.5 mm’lik serbest kanüllü kompresyon vidalarý ile oluþturulan subkondral raft konfigürasyonunun, postoperatif çökmeyi önlemede etkinliðini deðerlendirmektir. Hipotezimiz, bu tekniðin eklem yüzeyi çökmesini önleyerek fonksiyonel iyileþmeyi hýzlandýracaðý yönündedir.
Gereç ve Yöntem: Çalýþmaya; 18 yaþ ve üzeri, lateral tibia platosunda 10 mm’den fazla çökme saptanan ve etkilenen dizinden daha önce geçirilmiþ cerrahi öyküsü bulunmayan toplam 21 hasta dahil edildi. Tüm hastalarda tek anterolateral yaklaþýmla açýk redüksiyon yapýlarak serbest 5.5 mm’lik kanüllü kompresyon vidalarý ile subkondral raft konstrüksiyonu oluþturuldu. Hiçbir hastada greft uygulamasý yapýlmadý. Ameliyat sonrasý 12. ayda hastalar, Rasmussen Klinik Skoru (RKS) ve Rasmussen Radyolojik Skoru (RRS) ile radyolojik ve fonksiyonel açýdan deðerlendirildi.
Bulgular: Ortalama preoperatif eklem yüzeyi depresyonu 14.7 mm iken, bir yýllýk takipte 1.1 mm’ye; ortalama kondiler geniþleme ise 5.3 mm’den 0.7 mm’ye geriledi. Ameliyat sonrasý ortalama hastanede yatýþ süresi 3.7 gün, iþe dönüþ süresi ise 3.5 ay olarak saptandý. Postoperatif 1. yýl fonksiyonel ve radyolojik sonuçlar iyi düzeyde olup ortalama RKS 26.6 ve RRS ise 16.6 bulundu.
Sonuç: Uygulamýþ olduðumuz 5.5 mm’lik kanüllü kompresyon vidalarý ile oluþturulan subkondral raft tekniði, tibia plato kýrýklarýnýn tedavisinde postoperatif eklem yüzeyi çökmesini önleyen, iyileþmeyi hýzlandýran, basit ve etkili bir yöntemdir.

Anahtar Kelimeler: Tibia plato kýrýðý, subkondral raft, kanüllü kompresyon vidasý, erken rehabilitasyon, fonksiyonel iyileþme, Rasmussen skoru

A modified subchondral raft technique with free 5.5-mm cannulated compression screws for depressed tibial plateau fractures: A prospective observational study

Background: In tibial plateau fractures, achieving anatomical restoration of the articular surface and preventing postoperative collapse are critical for successful outcomes. Bone grafting is still commonly used to fill subchondral voids after reduction, but it carries risks such as donor site morbidity and technical difficulties. To avoid these issues and to provide stronger support, subchondral raft techniques have been developed. Although various screw and plate configurations have been investigated in the literature, there is still no clear consensus on the most effective method. We aimed to evaluate the effectiveness of our modified technique using 5.5-mm free cannulated compression screws in preventing postoperative collapse and improving functional recovery in tibial plateau fractures.
Methods: A total of 21 patients were included based on the following criteria: age ≥18 years, presence of >10 mm depression in the lateral tibial plateau, and no history of previous surgery on the affected knee. A subchondral raft construct was established without grafting, using free 5.5 mm cannulated compression screws. Postoperative evaluation at 12 months included radiological and functional assessments via the Rasmussen Clinical Score (RCS) and Rasmussen Radiological Score (RRS).
Results: The mean preoperative articular depression was 14.7 mm, improving to 1.1 mm at the one-year follow-up. Mean condylar widening decreased from 5.3 mm preoperatively to 0.7 mm postoperatively. The average postoperative hospital stay was 3.7 days, and the mean time to return to work was 3.5 months. At one year, radiological and functional outcomes were good, with a mean RCS of 26.6 and a mean RRS of 16.6.
Conclusion: The modified raft technique using 5.5-mm cannulated compression screws is a simple and effective option for managing depressed tibial plateau fractures, preventing articular collapse and enabling faster recovery.

Keywords: Tibial plateau fracture, subchondral raft, cannulated compression screw, early rehabilitation, functional recovery, Rasmussen score