External Fixation of Tibial Plateau Fractures: A Retrospective Evaluation and Case Report

Abstract

Tibial plateau fractures can be treated with casting, internal fixation and external fixation: each method has associated benefits and risks. We conducted a retrospective review of 40 patients at the University of Louisville Hospital with both open and closed tibial plateau fractures treated with external fixation. Complications were tabulated. In this review, 27.5 % of the patients experienced complications, which included superficial infection, deep infection, non-union, arthrosis, and/or operative modification or readjustment of the frame. We then compared our infection rates, superficial and deep, to established infection rate data for both external fixation and internal fixation. We achieved a lower rate of superficial infection and deep infection than Hutson and Zych's rate for fixators and Blokker et al.'s rate for open reduction internal fixation. Comparison of our combined (deep + superficial) infection rate to Schulak and Gunn's open reduction internal fixation rate provides additional support for external fixation as a satisfactory treatment method. These results support external fixation as at least as good as internal fixation with regard to infection. Lastly, we present a case in which a patient with an open tibial plateau fracture was treated successfully with external fixation without complication.

Internal fixation - casting - pin tract infection - deep infection - arthrosis - non-union

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