TITLE:
Lesional and Therapeutic Aspects of Tibial Plateau Fractures at the BSS University Hospital Center in Kati
AUTHORS:
Coulibaly Kalifa, Sanogo Cheick Oumar, Tambassi Sory Ibrahim, Diallo Aboubacar, Traoré Soumana, Touré Laye, Moussa Abdoul Kadri, Diallo Mahamadou, Diallo Cheickh Tidiane, Keïta Mohamed
KEYWORDS:
Fractures, Tibial Plateau, Pathology, Osteosynthesis
JOURNAL NAME:
Surgical Science,
Vol.13 No.10,
October
26,
2022
ABSTRACT: Introduction: Tibial plateau fractures are solutions of continuity of the
epiphyseal-metaphyseal block of the upper end of the tibia of which at least
one line enters the joint. They threaten the stability and mobility of the knee
and can compromise walking and standing. These fractures are on the increase,
especially affecting young and active subjects. Orthopedic treatment is a rare
indication apart from non-displaced or slightly displaced forms. Surgical
treatment is required in displaced forms, particularly in depression fractures.
The aim of this work was to report the
lesional and therapeutic aspects of tibial plateau fractures in our department. Patients and Method: Patients and method: This was a retrospective study
over 36 months from January 2019 to December 2021. Included in this study were
patients treated for a tibial plateau fracture in our department and followed
up for at least 10 months. The epidemiological and clinical data analyzed
were age, sex, affected side, etiology, mechanism of injury, pathological anatomy and associated lesions. The fractures were classified
according to the classification of Duparc and Ficat. The slightly or
non-displaced forms were treated orthopedically while the displaced forms were
treated surgically. The minimum follow-up was 10 months. The results were
evaluated by the anatomical criteria according to Mazas and Duparc and
functional according to Merle d’Aubigné. Results: The authors collected
71 cases of tibial plateau fractures. They accounted for 4.0% of all limb
fractures, 5.8%
of lower limb fractures and 33.8% of knee fractures in our service. The male
sex was the most represented at 78.9% with a sex ratio of 3.7. The age group of
[20 - 40] years was the most
affected, i.e., 53.5%.
The average age was 41 years with extremes of 17 and 82 years. The left side
was affected (n = 47) and the right side (n = 24). Road traffic accident was
the main cause. The mechanism of injury was mainly represented by lateral and
sagittal compressions. Lateral unituberosity and bi-tuberosity fractures were
the most frequent pathological types in our series, respectively 42.2% and
28.2%. The associated lesions were mainly represented by bone, ligament, skin
and neurological lesions. The treatment was orthopedic in 52.1% and surgical in
47.9%. According to the functional criteria of PMA, our results were very good
and good at 77.4%, Average at 14.1% and poor at 8.5%. Conclusion: It appears in this study that fractures of the
tibial plateaus are frequent and serious because of their articular nature.
Lateral and sagittal compressions are the most evoked injury mechanisms.
Lateral unituberosity and bituberosity fractures are the most frequent
pathological types. Functional and anatomical results are significantly better
with surgical treatment.