Fractures of the tibial plateau: a review of ninety-five patients and comparison of treatment methods.

Ninety-five patients with fractures of the tibial plateau have been reviewed. The fractures were grouped, according to the X-ray pattern, into five fracture types. Treatment was grouped into plaster immobilization or traction in the conservative group, and open reduction with internal fixation, open reduction with bone grafting, or open reduction with internal fixation and bone grafting in the operated group. It was concluded from this review that tibial plateau depression or tibial plateau widening of less than 10 mm was usually tolerated well and did not preclude a successful result. Adequacy of reduction was a least as important as early motion in obtaining a satisfactory result regardless of the type of fracture treated. If open reduction is undertaken both internal fixation and bone grafting are required in the most common types of these fractures. The exceptions are Type I or split fractures which do not require a bone graft and Type III or central depression fractures which do not require internal fixation.