Results of surgical treatment of tibial plateau fractures in a general hospital of the Leningrad oblast

Introduction. Fractures of the tibial plateau are one of the most complex intraarticular fractures of the extremities. High rate of unsatisfactory treatment results of these injuries is associated with the complexity of the injury itself as well as with poor preoperative planning and execution of surgery.

Aim of the study: to analyze anatomical and mid-term clinical outcomes of patients with intraarticular fractures of the tibial plateau who underwent surgical treatment at the level 1 trauma center of the Interdistrict Clinical Hospital of Vsevolozhsk from 2020 to 2022.

Materials and Methods. Study enrolled 60 patients with 62 intraarticular fractures of the proximal tibia who received surgical treatment. All patients underwent a CT scan of the knee joint. Fracture type was determined according to the AO/ASIF classification, the J. Schatzker’s classification modified in 2018, and the column classification. Follow-up examinations took place at 6 and 12 months after surgery. We assessed the radiographs, functional outcome according to the Lysholm and KSS scales, and the complications.

Results. Anatomical reduction of the articular surface of the tibial plateau was achieved in 49 patients (79%). At 6 months, the functional outcome according to Lysholm scale (Me and Q1; Q3, respectively) was 73 (68; 78) points, according to KSS - 73 (70; 78) points. At 12 months the median score according to Lysholm scale was 92 (86; 95), and according to KSS scale - 93 (88; 95), which corresponds to an excellent functional result.

Conclusion. Fracture osteosynthesis of type 41 C as well as types 41 B2.1 and B3.1 with impression of the posterolateral fragment requires precise topical diagnostics of the injury using pre- and postoperative CT, extended surgical approaches and their combinations, anatomic reduction of bone fragments, reconstruction of bone defect and stable fixation with combination of plates and screws.

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