SRINAGARIND MEDICAL JOURNALVolume 35, No. 01, Month JANUARY, Year 2020, Pages 2 - 6
Conservative treatment vs internal fixation in non-displaced tibial plateau fracture; retrospective cohort study
Naruepol Ruangsillapanan,Urawit Piyapromdee, Wasit Panoinont
Abstract Download PDFBackground 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 nondisplaced
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: Sixty-five 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
tibia plateau fracture,conservative treatment