Clinical and radiological significance of posteromedial fragment in tibial plateau fractures

Mehmet Akdemir; Mehmet Aykut Türken; Ahmet Cemil Turan; Ahmet Çağdaş Biçen; Ali İhsan Kılıç

doi:10.1016/j.jor.2022.04.012

Clinical and radiological significance of posteromedial fragment in tibial plateau fractures

J Orthop. 2022 Apr 25:31:110-116. doi: 10.1016/j.jor.2022.04.012. eCollection 2022 May-Jun.

Authors

Mehmet Akdemir¹, Mehmet Aykut Türken², Ahmet Cemil Turan³, Ahmet Çağdaş Biçen², Ali İhsan Kılıç⁴

Affiliations

¹ Department of Orthopedics and Traumatology, Ekol Hospital, Izmir, Turkey.
² Department of Orthopedics and Traumatology, Medikal Park Izmir Hospital, Izmir, Turkey.
³ Department of Orthopedics and Traumatology, Private Clinic, Izmir, Turkey.
⁴ Department of Orthopedics and Traumatology, Izmir Bakircay University, Izmir, Turkey.

Abstract

Introduction: The effect of joint fragmentation, especially the posteromedial fragment, on treatment outcomes in tibial plateau fractures has been better understood in recent years. In this study, we wanted to examine whether the accompanying posteromedial fragment has an effect on clinical and radiological results.

Patients and methods: Patients who underwent open reduction and internal fixation with plate and screw due to tibial plateau fracture were retrospectively screened. The patients were divided into two groups as with and without posteromedial fragment. Clinical, radiological and complications were compared statistically.

Results: 38 out of 52 patients were included in the study. The mean age of the patients was 46.08, 26 (68.42%) were female and 12 (31.58%) were male. Mean follow-up was 18.55 months. Posteromedial fragment was present in 21 (55.6%) patients, but not in 17 (44.4%) patients. When the two groups were compared according to the Rasmussen clinical and radiological criteria, no statistically significant difference was found. There was no statistically significant difference between the two groups in the rates of infection, non-union, malunion, joint separation, early arthrosis and arthrofibrosis (p > 0.05). A statistically significant difference was found between the two groups in terms of reduction loss rates (p < 0.05).

Conclusions: The accompanying tibial plateau fractures of the posteromedial fragment are characteristic fractures. Care should be taken to maintain the stability of the fracture fixation.

Keywords: Internal fixation; Posteromedial fragment; Tibial plateau fracture.