Mehmet Akdemir1, Mehmet Aykut Türken2, Ahmet Cemil Turan3, Ahmet Çağdaş Biçen2, Ali İhsan Kılıç4. 1. Department of Orthopedics and Traumatology, Ekol Hospital, Izmir, Turkey. 2. Department of Orthopedics and Traumatology, Medikal Park Izmir Hospital, Izmir, Turkey. 3. Department of Orthopedics and Traumatology, Private Clinic, Izmir, Turkey. 4. Department of Orthopedics and Traumatology, Izmir Bakircay University, Izmir, Turkey.
Abstract
Introduction: The effect of joint fragmentation, especially the posteromedial fragment, on treatment outcomes in tibial plateau fractures has been better understood in recent years. In this study, we wanted to examine whether the accompanying posteromedial fragment has an effect on clinical and radiological results. Patients and methods: Patients who underwent open reduction and internal fixation with plate and screw due to tibial plateau fracture were retrospectively screened. The patients were divided into two groups as with and without posteromedial fragment. Clinical, radiological and complications were compared statistically. Results: 38 out of 52 patients were included in the study. The mean age of the patients was 46.08, 26 (68.42%) were female and 12 (31.58%) were male. Mean follow-up was 18.55 months. Posteromedial fragment was present in 21 (55.6%) patients, but not in 17 (44.4%) patients. When the two groups were compared according to the Rasmussen clinical and radiological criteria, no statistically significant difference was found. There was no statistically significant difference between the two groups in the rates of infection, non-union, malunion, joint separation, early arthrosis and arthrofibrosis (p > 0.05). A statistically significant difference was found between the two groups in terms of reduction loss rates (p < 0.05). Conclusions: The accompanying tibial plateau fractures of the posteromedial fragment are characteristic fractures. Care should be taken to maintain the stability of the fracture fixation.
Introduction: The effect of joint fragmentation, especially the posteromedial fragment, on treatment outcomes in tibial plateau fractures has been better understood in recent years. In this study, we wanted to examine whether the accompanying posteromedial fragment has an effect on clinical and radiological results. Patients and methods: Patients who underwent open reduction and internal fixation with plate and screw due to tibial plateau fracture were retrospectively screened. The patients were divided into two groups as with and without posteromedial fragment. Clinical, radiological and complications were compared statistically. Results: 38 out of 52 patients were included in the study. The mean age of the patients was 46.08, 26 (68.42%) were female and 12 (31.58%) were male. Mean follow-up was 18.55 months. Posteromedial fragment was present in 21 (55.6%) patients, but not in 17 (44.4%) patients. When the two groups were compared according to the Rasmussen clinical and radiological criteria, no statistically significant difference was found. There was no statistically significant difference between the two groups in the rates of infection, non-union, malunion, joint separation, early arthrosis and arthrofibrosis (p > 0.05). A statistically significant difference was found between the two groups in terms of reduction loss rates (p < 0.05). Conclusions: The accompanying tibial plateau fractures of the posteromedial fragment are characteristic fractures. Care should be taken to maintain the stability of the fracture fixation.
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