Abstract:
Introduction. Tibial plateau fractures represent about 1% of the total fractures in the general population,
8% among old people, and 56.9% of the proximal tibia fractures. The sex distribution is an alternating one,
in men, the most traumas of this kind are registered at the average age of 40-44 years, and in women, it is
55-59 years. Tibial plateau fractures most often occur through an indirect mechanism, valgus/varus
movements, or vertical shock. Tibial plateau fractures at different ages, most often, have different
production mechanisms. Tibial plateau fractures in the elderly occur as a result of falls with low kinetic
energy (falls from one's height, slips, etc.), this is due to osteoporotic changes that occur in old age,
especially in women who have more severe osteoporosis. Injuries characterized by high kinetic energy
predominate among young people, such as road accidents, falls from high locations, and sports trauma.
Tibial plateau fractures affect knee alignment, stability, and movement. Early detection and appropriate
treatment are critical in minimizing the patient's disability and reducing the risk of complications, especially
post-traumatic arthritis.
Aim of study. To emphasize the diagnostic methods and the results of the treatment of tibial plateau
fractures treated in Orthopedics and Traumatology Clinic „V. Bețișor” during 2019.
Methods and materials. We analyzed 62 clinical cases: 32 men and 30 women; The mean age was 60
years among men and 64 years among women, and the general mean age was 61 years. As of Schatzker
classification, there were 7 cases of type I, 12 – type II, 10 – type III, 12 – type IV, 12 – type V and 9 cases
of type VI. CT scan and radiography were performed in 57 cases, while only radiography was done in 5
cases. 52 cases of habitual trauma, 6 car accidents, 2 sports trauma, and 2 cases of aggression were reported.
Surgical treatment was done in 38 cases. Open reduction and internal fixation was done in 33 cases, closed
reduction and internal fixation - 5 cases (4 percutaneous screws, 1 external fixator). 24 cases were solved
by conservative treatment because of no absolute indications for surgical treatment or because of the very
high anesthesia risks.
Results. Postoperative follow-up was performed at 6, 12, 18, and 24 weeks. Patients were evaluated
according to the Knee Society Clinical Rating System with an average of 85 points. One case of death on
the 11th day of hospitalization was caused by comorbidities. Complications occurred in 5 cases (infection
of the incision).
Conclusion. The best results and less complications were achieved during a close and personalized
approach to each case when proper investigations and methods of reduction, fixation were done and the
patient’s compliance was good.
