Results Following Operative Treatment of Tibial Plateau Fractures

Abstract

A total of 96 displaced tibial plateau fractures in 94 patients (average age, 48 years) were treated with open reduction and internal fixation. At 12 months postoperatively, mean range of knee motion was 126 degrees and 10 (10%) of the patients had required a secondary surgery. Using a binary regression model, no demographic variable such as age, gender, smoking history, diabetes, BMI; or fracture characteristic such as mechanism of injury, initial plateau depression, Schatzker classification was identified that correlated with short-term functional outcome such as a complication, range of motion, healing time, or residual depression. We determined that radiographic fracture reduction was not superior following fractures with less initial displacement, and increased plateau collapse at 12 months postoperatively was not indicative of decreased function. However, an increased postoperative articular step-off was found to be associated with an increased risk of plateau collapse (p < 0.01). Furthermore, at 12 months, 76% of the patients had returned to their preinjury employment and the overall complication rate was 13%.

The morphological features of different Schatzker types of tibial plateau fractures: a three-dimensional computed tomography study

“…However, identification of depression morphological characterization would facilitate surgical plan and therapeutic effect postoperatively [10]. Failure to accomplish the reduction of depression is associated with residual pain, post-traumatic arthritis, and deformity [10–12]. …”

Adverse Events, Length of Stay, and Readmission After Surgery for Tibial Plateau Fractures

“…1 Open reduction and internal fixation (ORIF) of displaced tibial plateau fractures aims to restore an anatomic joint surface and allow for early motion without loss of reduction. 1,2,[4][5][6] Much of the available information on tibial plateau fractures has focused on long-term outcomes after ORIF. 1,2,[4][5][6] Much of the available information on tibial plateau fractures has focused on long-term outcomes after ORIF.…”

“…2,3 Despite these efforts, tibial plateau fractures are associated with a number of short-and long-term postoperative complications, such as infection, joint stiffness/arthritis, malunion/nonunion, and compartment syndrome. [1][2][3]7,8 The only short-term outcome that has been assessed is risk of infection, and these data come from relatively small cohort studies. [1][2][3]7,8 The only short-term outcome that has been assessed is risk of infection, and these data come from relatively small cohort studies.…”

Definitive Fixation of Tibial Plateau Fractures

“…The senior author (KAE) prefers this approach because it not only allows for a more facile closure, but also has minimized soft tissue complications in his practice. 30,31 The flap should be tagged with absorbable suture, which allows for easy retraction and visualization of deeper structures (see Fig. 3F).…”