Results of tibia plateau fractures

SUMMARYIntroduction: Fourthy-three patients who were diagnosed as tibia plateau fracture and operated in our hospital Celal Bayar University, Medical Faculty Orthopaedics & Traumatology between January 2005 ? March 2012 were analysed retrospectively.Patients and Methods: Fifty-three patients were found according to hospital records & charts. One patient died after 1 week at the intensive care unit because of polytrauma and 9 others could not be reached because of address change. So 43 knees of 43 patients were taken into our study. Mean age of the patients was 44,7 years (20-72). 33 patients were male (%76,7) and 10 were female (23,3).Avarage follow up time was 38,07 (8-72) months. Our indications for surgery were;1- Intraarticular displacement ? 2 mm2- Methaphyseal - Diaphyseal Translation > 1 cm3- More then 10 ° of (varus-valgus) angular deformity in coronal and/or sagittal axis4- Open fractureNon-displaced fractures and patients who could not tolerate general anesthesia because of high ASA risk were treated conservatively. All patients went through bilateral lower extremity telemetric length x-rays postoperatively and Rasmussen evaluation criteria were used for radiological assesment. Postoperative reduction of 2 mm or less was recognised to be anatomical. Functional results were evaluated with KSKS (Knee Society Knee Score) and KSFS (Knee Society Function Score).Kellgren-Lawrence radiological evaluation score was used to determine the relationship between trauma and osteoartritis postoperatively.Results: Our results were good- excellent in according to; Knee scores: % 76.7, functional scores: %79.1, Rasmussen radiologic stage: %79.2 of our patients. Stage of osteoartritis increased as the patient age increased (p=0,009). Patients over 40 years old had higher osteoartritis stage the patients under 40 years old (p=0,005). Average functional score of the patients under 40 years old was 88 where as average functional score of patients over 40 was 77 and this difference was found to be statisticaly significant p=0,029. Patients with reduction of 2 mm and lower were found to have statisticaly significantly higher KSS knee scores then patients with a reduction of 2 mm and higher (p=0,31) and also functional scores of this group of patients was also higher (p=0,004). High energy fractures (4,5,6 and C1,2,3) were found to have significantly lower functional and knee scores according to both Schatzker and AO-OTA classification; and these patients were in an statisticalysignificant higher osteoartritis stage. Patients with ligament injury were found to have statisticaly significant lower knee (p= 0,034) and functional (p=0,039) scores.Conclusion: Low energy, anatomical reduction and knee stability were found to be the most important parameters in determining mid term prognosis according to knee and functional scores. Patients with bicondilar fracture were found to have permanent functional loss compared to the other group of patients.Key words: Tibia plateau, Knee function