Abstract:
Introduction. Fractures of the tibial plateau are articular fractures that can severely affect the
function of the knee if a not treated or treated incorrect. Often the definitive diagnosis is made
postoperatively or remains without details due to the wide association of lesions of soft
structures, invisible on radiological lines.
Aim of the study. Analyzing of contemporary methods of treatment and diagnosis of tibial
plateau fractures
Materials and methods. This information is based on a review of different articles from the
open access databases: PubMed, PMC and GoogleScholar, using the
Results. Tibial plateau fractures are complex injuries that most often affect young adults or the
‘third age’ population. These fractures usually have associated soft-tissue lesions that will
affect their treatment. Associated soft tissue injuries in tibial plateau fractures can be divided
as soft tissue envelope lesions, neurovascular injuries and intra-articular lesions. Lesions of the
ligaments and/or the menisci has been reported in several studies and may contribute, if not
properly treated, to the substandard outcomes associated with this type of fractures.
Traditionally, meniscal tears are reported in 20-50% cases of all the tibial plateau fractures,
while ligaments lesions are reported in 10-30%. Typically the Schatzker or AO/OTA
classification is used, but the concept of the proximal tibia as a three-column structure and the
detailed study of the posteromedial and posterolateral fragment morphology has changed its
treatment strategy. Partially articular factures can be treated by minimally-invasive methods
and arthroscopy is useful to assist and control the fracture reduction and to treat intra-articular
soft-tissue injuries. The imaging studies routinely performed for tibial plateau fractures are
plain anteroposterior and lateral radiographs and threedimensional CT, while MRI has not yet
become a standard tool. The final outcome of surgical treatment may be influenced by
associated lesions of the menisci or of the knee ligaments.
Conclusions. Tibial plateau fractures are severe injuries, usually associated with soft-tissue
lessions and complications. Minimally-invasive osteosynthesis, when possible, is
recommended in partial articular fractures. The indications of the surgical treatment appear
from: the state of the soft tissues, the quality of the bone, the type fractures and conditions for
early rehabilitation of the patient. Patients suffering a tibial plateau fracture should be aware of
the residual pain and functional limitations that can appear in the mid- and long-term.
Description:
Department of Orthopedics and Traumatology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 8th International Medical Congress for Students and Young Doctors, September 24-26, 2020