The Prognosis of Management Following Tibial Plateau Fractures

Background: Tibial Plateau Fractures (TPF) consist for one percent of all treated fractures. Open Reduction Internal Fixation (ORIF) and reconstruction of articular surfaces are the mainstay of management. In this study, we sought to assess the risk of identifying cases with high risks for poor postoperative outcomes. Methods: A total of 123 tibial plateau fractures treated at the Basrah Teaching Hospital were prospectively enrolled. The demographics, injury data, surgical management and SMFA scores were obtained. Variables included sex, age, BMI, comorbidity, open fracture, high-energy injury mechanisms, vascular or nerve injuries, residual TP depression, tibial spine fracture and OTA fracture types. Results: Morbidity was recorded in 55(44.7%) patients. Seventy-one patients smoked during the study period. The high-energy mechanism of trauma was documented in 55.3% of cases, whereas low-energy was found in 44.7% of cases. Compartment syndrome was reported in 34.1% of cases. Open fractures were observed in 32.5% of the cases. The tibial spine was involved in 29.3% of cases. OTA class (C) was more frequently reported than class (B) (63.4% vs. 36.6%). Residual tibial plateau depression was reported in 43.1% of cases. The preoperative fracture depression range value was 1-39 mm while the postoperative fracture depression range was 0-5.5 mm. Conclusion: SMFA score was used to assess the risk of postoperative dysfunction. Older age, obesity, severe comorbidity, tobacco smoking, alcohol consumption, high trauma energy, large postoperative depression, tibial spine involvement, female sex, complicated open fracture, type C fracture and high SMFA score are predictive risk factors for poor outcomes. Conflict of Interest declaration: The authors declare that they have no affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript.