Tibial plateau fracture natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]
Overview
If left untreated, majority of patients with tibial plateau fracture may progress to develop malunion and loss of range of motion of the knee. Common complications of tibial plateau fracture include knee stiffness, malunion, nerve injuries, and post traumatic arthritis. Prognosis is generally good, with most patients can resume their previous level of activity, including competitive sports.
Natural History, Complications, and Prognosis
Natural History
- If left untreated, majority of patients with tibial plateau fracture may progress to develop malunion and loss of range of motion of the knee and early post traumatic arthritis.[1][2]
Complications
- Complications can be divided into early and late.[3][4][5][6]
- Most early complications can be viewed as biologic failures, whereas late complications are often associated with problems.
Early Complications
Early complications include the following:
- Compartment syndrome
- Vascular injuries
- Loss of reduction
- Swelling and wound-healing problems
- Infections
- Deep vein thrombosis
- Nerve injuries
Late Complications
Late complications include the following:
- Knee stiffness
- Knee instability
- Angular deformities
- Late collapse
- Nonunion
- Implant breakage
- Malunion
- Post traumatic arthritis
Prognosis
- Prognosis is generally good, with most patients can resume their previous level of activity, including competitive sports.[7][8]
- Most patients will likely lose a few degrees of final flexion and extension, and possibly rotation as well; however, these limitations generally do not prevent full function.
- Some patients are unable to resume their prior level of functioning.
- All treatment approaches have a percentage of poor results, with decreased flexion and extension, prominent implants, ligamentous instability, and degenerative joint disease.
References
- ↑ Azar, F., Canale, S., Beaty, J. & Campbell, W. (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. Page: 1898-2028.
- ↑ Handoll HHG, Madhok R. Conservative interventions for treating distal radial fractures in adults (Review). The Cochrane Library. 2008;4:1-112.
- ↑ Ramponi DR, McSwigan T (2018). "Tibial Plateau Fractures". Adv Emerg Nurs J. 40 (3): 155–161. doi:10.1097/TME.0000000000000194. PMID 30059369.
- ↑ Rockwood, Charles (2010). Rockwood and Green's fractures in adults. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781605476773.
- ↑ Singleton N, Sahakian V, Muir D (2017). "Outcome After Tibial Plateau Fracture: How Important Is Restoration of Articular Congruity?". J Orthop Trauma. 31 (3): 158–163. doi:10.1097/BOT.0000000000000762. PMID 27984441.
- ↑ Dubina AG, Paryavi E, Manson TT, Allmon C, O'Toole RV (2017). "Surgical site infection in tibial plateau fractures with ipsilateral compartment syndrome". Injury. 48 (2): 495–500. doi:10.1016/j.injury.2016.10.017. PMID 27914662.
- ↑ Papagelopoulos PJ, Partsinevelos AA, Themistocleous GS, Mavrogenis AF, Korres DS, Soucacos PN (2006). "Complications after tibia plateau fracture surgery". Injury. 37 (6): 475–84. doi:10.1016/j.injury.2005.06.035. PMID 16118010.
- ↑ Mehin R, O'Brien P, Broekhuyse H, Blachut P, Guy P (2012). "Endstage arthritis following tibia plateau fractures: average 10-year follow-up". Can J Surg. 55 (2): 87–94. doi:10.1503/cjs.003111. PMC 3310762. PMID 22269220.