Treatment of complex tibial plateau fracture associated with anterior tibial tubercle involvement.

Abstract

Introduction Fractures in both tibial plateaus occur following high-energy traumatisms. Sometimes, fracture can compromise the tibial tubercle. Neither the Schatzker nor the AO/OTA classifications take this fragment into account. The aim of this study was to describe incidence and surgical management in these types of fractures. Materials and Methods We carried out a retrospective study between 2009 and 2017 which included 48 fractures in both tibial plateaus treated with reduction and osteosynthesis; 10 of them showed a fragment of the tibial tubercle associated. Seven patients were males, whereas 3 of them were females. Patients averaged 33.5 years old. Nine of them received initial stabilization by external fixator. The fragment of the tibial tubercle was fixed using 2 3.5-mm screws (9 cases) and 1/3 tubular plate (one case). One patient had suffered an open fracture. Minimal follow-up was 12 months. Results We got bone healing in all the cases. There were no infections. Knee ROM was 10º-extension (0º-20º) and 120ºflexion (90º-140º). In one case it was necessary to remove the osteosynthesis material. One patient required arthroscopy to treat a meniscal injury. Conclusions In our series, 20.8% of all fractures in both tibial plateaus showed one fragment from the tibial tubercle. The fixation of this fragment with 3.5-mm screws or a 1/3 tubular plate is an effective technique to get adequate stabilization for the fragment.

Keywords

• Fractura de platillo tibial
• tuberosidad anterior
• fractura compleja de tibia proximal.