Tibial plateau fractures-Does non anatomic reduction lead to an adverse outcome? A 10-year follow-up

Najmul Huda; Mir Shahid Ul Islam; Altaf Hussain; Sandeep Bishnoi; Ravi Dholariya; Aijaz Ahmad Ganai

Tibial plateau fractures-Does non anatomic reduction lead to an adverse outcome? A 10-year follow-up

Int J Burns Trauma. 2021 Aug 15;11(4):321-327. eCollection 2021.

Authors

Najmul Huda¹, Mir Shahid Ul Islam¹, Altaf Hussain¹, Sandeep Bishnoi¹, Ravi Dholariya¹, Aijaz Ahmad Ganai¹

Affiliation

¹ Department of Orthopaedic Surgery, Teerthankar Mahaveer University Moradabad 244001, Uttar Pradesh, India.

PMID: 34557335
PMCID: PMC8449151

Abstract

Purpose: Assess the effect of residual intra-articular step and limb alignment on the outcomes of operated tibial plateau fractures.

Methods: After retrospectively enrolling 123 cases of operated tibial plateau fracture whole limb weight bearing X-rays of both knees and computed tomography scan was done to record the presence of knee osteoarthritis (OA), alignment and articular step. The Rasmussen functional score (RFS) and Visual Analogue scale (VAS) score was calculated. Depending on the articular step there were four groups, group A (no step), group B (<2 mm), group C (2 mm-5 mm) and group D (6 mm-10 mm). The patients were also divided into 3 groups based on knee alignment, group 1 (0-10° valgus angle), group 2 (varus angle upto 5°) and group 3 (varus angle of 5-15°).

Results: Group A had 53, group B 31, group C 23 and group D 16 cases. The mean follow up was 10.23 years. The difference in the RFS/VAS score and OA rate amongst the 4 groups based on articular step had a P>0.05. Based on knee alignment RFS and OA rate amongst three groups had a P<0.05 with better results in group 1.

Conclusions: Mal-alignment is a more important predictor of outcome in operated tibial plateau fractures than articular step.

Keywords: Tibial plateau fractures; X rays; fixation.