A selection of published medical articles (most recent first) about Tibial Plateau Fractures (TPF).
Because our team are always combing the medical literature for their editorial work, we thought it might be useful to others to see what we have been reading, and have put a link to the abstract available on PubMed. Where possible, we have located a copy of the full article and added a link, but your local library will also be able to obtain a reprint for you.
"The mean follow-up period was 2 ½ years. The mean postoperative knee flexion was 128°. All patients could walk, jump, and climb steps. 90% could squat, though only 50% could duck walk properly."
Outcome of Schatzker type V and VI tibial plateau fractures. Pun TB, Krishnamoorthy VP, Poonnoose PM, Oommen AT, Korula RJ. Indian J Orthop. 2014 Jan;48(1):35-41. [Link to free full text article]
"Bicondylar tibial plateau fractures are serious injuries to a major weight-bearing joint. These injuries are often associated with severe soft tissue injuries that complicate surgical management". "....fine-wire circular external fixation, combined with limited open reduction and cannulated screw fixation, consistently produces good functional results without serious complications."
Bicondylar tibial plateau fractures treated with fine-wire circular external fixation. Strategies Trauma Limb Reconstr. 2014 Apr;9(1):25-32. [Link to free full text article with illustrations]
"...what we are calling "anterior tibial condyle fracture". These fractures are often missed on routine antero-posterior and lateral knee X-rays due to an overlap between the fracture and the normal bone."
"...this injury is often missed. They should be suspected, diagnosed early and treated by reconstruction of anterior condyle, posterior cruciate ligament reconstruction."
Anterior tibial plateau fracture: An often missed injury. Maheshwari J, Pandey VK, Mhaskar VA. Indian J Orthop. 2014 Sep;48(5):507-10.
"Classifying tibial plateau fractures is important for physician-to-physician communication (for clinical and research purposes), for estimation of prognosis, and for planning surgery; however, the possible patterns of injury are innumerable, and no classification system can capture all injuries."
"Even so, the Schatzker system has many advantages, including its familiarity, ease of use, and generally good reliability. Its major shortcomings come into play where complex, high-energy fracture patterns are concerned, and when 3-D imaging tools are required..."
Classifications in brief: Schatzker classification of tibial plateau fractures. Zeltser DW, Leopold SS. Clin Orthop Relat Res. 2013 Feb;471(2):371-4. [Link to free full text article]
"The Schatzker classification system for tibial plateau fractures is widely used by orthopedic surgeons to assess the initial injury, plan management, and predict prognosis. Many investigators have found that surgical plans based on plain radiographic findings were modified after preoperative computed tomography (CT) or magnetic resonance (MR) imaging."
Schatzker classification of tibial plateau fractures: use of CT and MR imaging improves assessment. Markhardt BK, Gross JM, Monu JU. Radiographics. 2009 Mar-Apr;29(2):585-97.
"The purpose of this study was to evaluate the outcome of open severe comminuted tibial plateau fractures treated with minimal internal fixation and circular external fixation frames."
"The most significant disadvantage of the technique is insufficient anatomical reduction and loss of reduction in comminuted posterior wall fractures in the coronal plane. This technique should be combined with a minimally invasive internal fixation method..."
Outcome of open comminuted tibial plateau fractures treated using an external fixator. Subasi M, Kapukaya A, Arslan H, Ozkul E, Cebesoy O. J Orthop Sci. 2007 Jul;12(4):347-53.
Because of deep wound infection involving other serious complications "patients with comminuted tibial plateau fractures requiring either two buttress plates or a single plate with additional interfragmentary lag screws would probably be better managed by either non-operative treatment or limited internal fixation.".
Complications of internal fixation of tibial plateau fractures. Young MJ, Barrack RL. Orthop Rev. 1994 Feb;23(2):149-54.
"Comminuted bicondylar tibial plateau fractures remain a difficult problem for the orthopaedic surgeon. Treatment has ranged from traction to cast immobilization to open reduction and internal fixation; none of these has emerged as ideal. "
Internal versus external fixation of bicondylar tibial plateau fractures. Mallik AR, Covall DJ, Whitelaw GP. Orthop Rev. 1992 Dec;21(12):1433-6.
"Medial unicondylar and medially tilted bicondylar fractures tended to redisplace into varus position and lateral unicondylar and laterally tilted bicondylar fractures into valgus."
"Varus alignment of the tibial plateau was tolerated worse than valgus alignment."
Classification of fractures of the tibial condyles. Honkonen SE, Järvinen MJ. J Bone Joint Surg Br. 1992 Nov;74(6):840-7. [Link to free full text article]
"...anatomic reduction of plateau fractures, in addition to early motion, is a major factor contributing to successful management of this potentially disabling injury."
Tibial plateau fractures: definition, demographics, treatment rationale, and long-term results of closed traction management or operative reduction. Moore TM, Patzakis MJ, Harvey JP. J Orthop Trauma. 1987;1(2):97-119.