Surgical Treatment of Tibial Plateau Fractures About 100 Cases

Abstract

Tibial plateau fractures are articular fractures that must benefit from anatomical reduction to avoid the occurrence of complications, a source of serious functional sequelae. Their management has become largely surgical. We report a retrospective study of 100 tibial plateau fractures treated surgically between 2012 and 2018. The objectives were to study the epidemiological characteristics of tibial plateau fractures, to evaluate and compare the clinical and radiological results, in the short and long term, of different techniques for the surgical treatment of tibial plateau fractures. The average age of our patients was 45 years old. The male sex was affected in 66% with a sex ratio of 1.94. The etiologies were dominated by domestic accidents in 52% of cases, followed by public voting accidents (47%). The fracture was open in 3 cases. We adopted the classifications of DUPARC and FICAT and of SCHATZKER, thus the patients were classified: 30 cases of unituberosity fractures, 41 cases of spinotuberosity fractures and 29 cases of bituberosity fractures. Stabilization was provided by a screwed plate in 62 cases and by screwing in 32 cases, 26 of which were percutaneous. Only 1 patient had stabilization with a HOFFMAN-type external fixator for an open CAUCHOIX II fracture. 5 patients had an ILIZAROV type external fixator. Autologous corticocancellous bone grafting was performed in 12 cases. According to the criteria of HOLH AND LUCK, the anatomical results were satisfactory in 77% of cases. According to the criteria of MERLE AUBIGNE and MAZAS, the functional results were satisfactory in 82% of cases. In the light of our results and a review of the literature, it appears that the prognosis of these fractures depends on the type of fracture, the degree of comminution, the quality of the reduction, the patient's age, the time to treatment, meniscal and ligament lesions, type of surgical treatment and quality of rehabilitation.