Download PDF
J Knee Surg 2013; 26(03): 161-166
DOI: 10.1055/s-0032-1324807
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Results Following Operative Treatment of Tibial Plateau Fractures

Adriana M. Urruela
1   Department of Orthopedic Surgery, NYU Hospital for Joint Diseases, New York, New York
,
Roy Davidovitch
1   Department of Orthopedic Surgery, NYU Hospital for Joint Diseases, New York, New York
,
Raj Karia
1   Department of Orthopedic Surgery, NYU Hospital for Joint Diseases, New York, New York
,
Sonya Khurana
1   Department of Orthopedic Surgery, NYU Hospital for Joint Diseases, New York, New York
,
Kenneth A. Egol
1   Department of Orthopedic Surgery, NYU Hospital for Joint Diseases, New York, New York
› Author Affiliations
Further Information

Publication History

13 December 2011

28 June 2012

Publication Date:
10 September 2012 (online)

    Permissions and Reprints

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%.

Keywords

tibial plateau - fracture - ORIF - Schatzker - outcome
 

  • References

  • 1 Rademakers MV, Kerkhoffs GM, Sierevelt IN, Raaymakers EL, Marti RK. Operative treatment of 109 tibial plateau fractures: five- to 27-year follow-up results. J Orthop Trauma 2007; 21 (1) 5-10
    CrossrefPubMedSearch in Google Scholar
  • 2 Moore TM, Patzakis MJ, Harvey JP. Tibial plateau fractures: definition, demographics, treatment rationale, and long-term results of closed traction management or operative reduction. J Orthop Trauma 1987; 1 (2) 97-119
    CrossrefPubMedSearch in Google Scholar
  • 3 Koval K, Zuckerman JD. Handbook of Fractures. 3rd ed. Lippincott Williams & Wilkins; 2006
    Search in Google Scholar
  • 4 Stevens DG, Beharry R, McKee MD, Waddell JP, Schemitsch EH. The long-term functional outcome of operatively treated tibial plateau fractures. J Orthop Trauma 2001; 15 (5) 312-320
    CrossrefPubMedSearch in Google Scholar
  • 5 Houben PF, van der Linden ES, van den Wildenberg FA, Stapert JW. Functional and radiological outcome after intra-articular tibial plateau fractures. Injury 1997; 28 (7) 459-462
    CrossrefPubMedSearch in Google Scholar
  • 6 Touliatos AS, Xenakis T, Soucacos PK, Soucacos PN. Surgical management of tibial plateau fractures. Acta Orthop Scand Suppl 1997; 275: 92-96
    PubMedSearch in Google Scholar
  • 7 Koval KJ, Helfet DL. Tibial plateau fractures: evaluation and treatment. J Am Acad Orthop Surg 1995; 3 (2) 86-94
    CrossrefPubMedSearch in Google Scholar
  • 8 Schatzker J, McBroom R, Bruce D. The tibial plateau fracture: the Toronto experience 1968–1975. Clin Orthop Relat Res 1979; (138) 94-104
    PubMedSearch in Google Scholar
  • 9 Carlson DA. Posterior bicondylar tibial plateau fractures. J Orthop Trauma 2005; 19 (2) 73-78
    CrossrefPubMedSearch in Google Scholar
  • 10 Ebraheim NA, Sabry FF, Haman SP. Open reduction and internal fixation of 117 tibial plateau fractures. Orthopedics 2004; 27 (12) 1281-1287
    PubMedSearch in Google Scholar
  • 11 Piper KJ, Won HY, Ellis AM. Hybrid external fixation in complex tibial plateau and plafond fractures: an Australian audit of outcomes. Injury 2005; 36 (1) 178-184
    CrossrefPubMedSearch in Google Scholar
  • 12 Dendrinos GK, Kontos S, Katsenis D, Dalas A. Treatment of high-energy tibial plateau fractures by the Ilizarov circular fixator. J Bone Joint Surg Br 1996; 78 (5) 710-717
    PubMedSearch in Google Scholar
  • 13 Katsenis D, Athanasiou V, Megas P, Tyllianakis M, Lambiris E. Minimal internal fixation augmented by small wire transfixion frames for high-energy tibial plateau fractures. J Orthop Trauma 2005; 19 (4) 241-248
    CrossrefPubMedSearch in Google Scholar
  • 14 Benirschke SK, Agnew SG, Mayo KA, Santoro VM, Henley MB. Immediate internal fixation of open, complex tibial plateau fractures: treatment by a standard protocol. J Orthop Trauma 1992; 6 (1) 78-86
    PubMedSearch in Google Scholar
  • 15 Honkonen SE. Indications for surgical treatment of tibial condyle fractures. Clin Orthop Relat Res 1994; (302) 199-205
    PubMedSearch in Google Scholar
  • 16 Jensen DB, Rude C, Duus B, Bjerg-Nielsen A. Tibial plateau fractures: a comparison of conservative and surgical treatment. J Bone Joint Surg Br 1990; 72 (1) 49-52
    PubMedSearch in Google Scholar
  • 17 Kiefer H, Zivaljevic N, Imbriglia JE. Arthroscopic reduction and internal fixation (ARIF) of lateral tibial plateau fractures. Knee Surg Sports Traumatol Arthrosc 2001; 9 (3) 167-172
    CrossrefPubMedSearch in Google Scholar
  • 18 Lachiewicz PF, Funcik T. Factors influencing the results of open reduction and internal fixation of tibial plateau fractures. Clin Orthop Relat Res 1990; (259) 210-215
    PubMedSearch in Google Scholar
  • 19 Lansinger O, Bergman B, Körner L, Andersson GB. Tibial condylar fractures. A twenty-year follow-up. J Bone Joint Surg Am 1986; 68 (1) 13-19
    Search in Google Scholar
  • 20 Porter BB. Crush fractures of the lateral tibial table: factors influencing the prognosis. J Bone Joint Surg Br 1970; 52 (4) 676-687
    PubMedSearch in Google Scholar
  • 21 Rasmussen PS. Tibial condylar fractures: impairment of knee joint stability as an indication for surgical treatment. J Bone Joint Surg Am 1973; 55 (7) 1331-1350
    PubMedSearch in Google Scholar
  • 22 Roberts JM. Fractures of the condyles of the tibia. An anatomical and clinical end-result study of one hundred cases. J Bone Joint Surg Am 1968; 50 (8) 1505-1521
    PubMedSearch in Google Scholar
  • 23 Scheerlinck T, Ng CS, Handelberg F, Casteleyn PP. Medium-term results of percutaneous, arthroscopically-assisted osteosynthesis of fractures of the tibial plateau. J Bone Joint Surg Br 1998; 80 (6) 959-964
    CrossrefPubMedSearch in Google Scholar
  • 24 Tscherne H, Lobenhoffer P. Tibial plateau fractures. Management and expected results. Clin Orthop Relat Res 1993; (292) 87-100
    PubMedSearch in Google Scholar
  • 25 Savoie F, Van Griend RA, Ward EF, Hughes JL. Tibial plateau fractures. A review of operative treatment using AO techniques. Orthopedics 1987; 10: 745-750
    PubMedSearch in Google Scholar
  • 26 Bowes DN, Hohl M. Tibial condylar fractures. Evaluation of treatment and outcome. Clin Orthop Relat Res 1982; (171) 104-108
    PubMedSearch in Google Scholar
  • 27 Stokel EA, Sadasivan KK. Tibial plateau fractures: standardized evaluation of operative results. Orthopedics 1991; 14 (3) 263-270
    PubMedSearch in Google Scholar
  • 28 Marsh JL, Buckwalter J, Gelberman R , et al. Articular fractures: does an anatomic reduction really change the result?. J Bone Joint Surg Am 2002; 84-A (7) 1259-1271
    PubMedSearch in Google Scholar
  • 29 Ali AM, El-Shafie M, Willett KM. Failure of fixation of tibial plateau fractures. J Orthop Trauma 2002; 16 (5) 323-329
    CrossrefPubMedSearch in Google Scholar
  • 30 Young MJ, Barrack RL. Complications of internal fixation of tibial plateau fractures. Orthop Rev 1994; 23 (2) 149-154
    PubMedSearch in Google Scholar