Conservative Treatment vs Internal Fixation in Non-displaced Tibial Plateau Fracture; Retrospective Cohort Study

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Naruepol Ruangsillapanan
Urawit Piyapromdee
Wasit Panoinont

Abstract

Background and objective: Tibial plateau fracture is a complex periarticular knee joint fracture that is mainly treated by internal fixation or conservative treatment in some cases. Although many studies have detailed techniques and outcomes of surgical fixation in tibial plateau fractures, minimal literature exists on the functional and radiological outcome of nonsurgical management. Despite literatures reporting good clinical outcome in internal fixation, patients that have been treated by conservative treatment in Maharat Nakhon Ratchasima Hospital have also reported good results according to research comparing clinical outcomes between the two groups. Nowadays the guideline of treatment in tibial plateau fractures remains controversial especially in non- displaced or minimally displaced fractures.This study sought to compare functional results and radiological results in patients with non-displaced tibial plateau fracture that are treated surgically and nonsurgically.


Methods : Over the last 6 years, 603 consecutive tibial plateau fracture were treated in Maharat Nakhonratchasima Hospital. Overall, 65 patients (11%) were non-displaced fracture and were available for follow-up for 12 weeks. 43 patients were treated nonsurgically and 22 patients were treated surgically. The functional results and radiological results were recorded by modified version of the knee scoring system of Hohl and Luck . The functional results and radiological results were compared between the two groups.


Results : 65 patients were included in this study. Overall, 95% of surgery group attained good to excellent functional results vs 91% in conservative group. 77% of surgery group attained good radiological results vs 47% in conservative group..


Conclusions : Conservative treatment in patients with non-displaced tibia plateau fracture is still an alternative option although it has a higher chance to collapse more than operative  group.

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References

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