The use of a metaphyseal sleeve total knee replacement as primary treatment for Schaztker VI tibial plateau fracture

Abstract

Traditional treatment of tibial plateau fractures is with open reduction and internal fixation, or external fixation in severely displaced and comminuted fractures. Total joint arthroplasty for unreconstructable hip fractures is a successful and widely accepted treatment; however, such surgery for tibial plateau fractures is not a common practice. We present two cases of highly comminuted schaztker VI tibial plateau fractures in patients over the age of 65. Both patients had a metaphyseal sleeve revision knee arthroplasty as delayed primary treatment. Both patients have had excellent clinical and radiographical results at 6 months and 5 years follow-up, respectively. We present the first description in the literature of this implants use for bone loss as a result of trauma. There is growing evidence that total joint arthroplasty is an effective treatment in tibial plateau fractures, in particular for elderly patients who may be at high risk of failure from internal fixation.