Tibial plateau fractures osteosynthesis—a case series of 88 patients evaluating surgical approaches, results and complications

Abstract

Background: Tibial plateau fractures can be treated using different surgical approaches and different fixation methods. With multiple surgical options available, optimal treatment is still controversial. With variable results, surgical osteosynthesis remains challenging, being the choice of appropriate fixation method fundamental for a favourable clinical outcome. Our goal is to analyse the surgical outcomes of patients with tibial plateau fractures submitted to osteosynthesis using different surgical approaches. Methods: There were 88 tibial plateau osteosynthesis performed over a 5-year period. Among others, surgical approach, fixation methods and surgical outcomes were analysed. Results: The overall complication rate was 11.4%, with deep infection being the most common. Single surgical approach had a lower complication rate (2.25%) than double approaches (33.3%). The type of plate used was not correlated with postoperative complications. Unsatisfactory surgical reductions were obtained in 15.9%. There was negative significant association between the baseline Schatzker classification and the reduction. The type of plate usage was not associated with unsatisfactory reductions, but locking compression plates (LCPs) were associated with more anatomical reductions comparing to compression plates. Bone graft was used in 51% of patients and there was no correlation with fracture reduction, fracture consolidation or postsurgical complications. Conclusions: The severity of the tibial plateau fracture is associated with the surgical outcomes. If an acceptable reduction can be obtained, single surgical approach and single plate osteosynthesis is a safer option than double surgical approaches with double plating.