Efficacy of composite allograft and demineralized bone matrix graft in treating tibial plateau fractures with bone loss.

Tibial plateau fractures with bone loss or significant comminution require grafting and stable fixation. We hypothesized a standardized protocol of internal fixation augmented with a mixture of demineralized bone matrix and corticocancellous allograft chips would result in high healing rates with minimal subsidence. Union was achieved in all 36 patients available for follow-up by a mean of 4.4 months. Mean range of motion was 2 degrees to 120 degrees. One patient developed osteomyelitis. Subsidence ranging from 2.5 to 5.7 mm occurred in 4 patients (11%). This treatment method provides sufficient structural integrity with a high union rate and a low complication rate.