Background: Tibial plateau fractures, complex injuries, are observed following high- and low-energy traumas. The main goals of the treatment are to restore the extremity alignment and articular surface, and to obtain the early knee motion and rehabilitate the patient. We aimed to evaluate the effect of trauma severity on clinical and radiological results in the treatment of tibial plateau fractures.
Methods: Of 49 patients with tibial plateau fractures, 18, 16 and 15 were treated with open reduction-internal fixation, closed reduction-internal fixation, and external fixation, respectively. A total of 53.1% of patients had low-energy fractures while 46.9% of them had high-energy type. Bone union occurred in a mean of 14.4 weeks and the patients’ extremities were allowed to bear full weight after bone union. Clinical and radiological results of the patients were evaluated according to Rasmussen criteria.
Results: The knee flexion motion was 128.5º in patients with low-energy fractures, while the knee flexion motion arc in high-energy fractures was detected as 97.5º. There was a statistically significant difference between two groups in terms of knee joint movement. Despite clinical outcomes in the patients with low-energy fractures were better when compared with high-energy fracture, but no statistical significance was detected. Radiological results in the patients with low-energy fractures were statistically significant better when compared with high-energy fractures.
Conclusion: Our study results suggest that the type of fracture and severity of trauma in surgical treatment of tibial plateau fractures are the main factors which affect functional and radiological results.
Sukru Demir and Oktay Belhan