Abstract

• The aim of treating a tibial plateau fracture is to gain a stable, pain free knee motion, and to repair all associated lesion. Recently a preferred treatment is the open reduction and internal fixation of all displaced and unstable tibial plateau fracture in order to gain anatomic reduction and early knee motion. But functional recovery is relatively impaired in complex knee trauma, despite various treatment modalities. Observations based on long-term radiologicexaminations frequently did not correlate with the functional end results. When choosing the treatment modalities, there are many factors to consider which will influence the final results.
  Forty-seven cases of tibial plateau fractures were treated from August 1988 to March 1995 and the average follow up period was fouty-eight months. The results were as follows:
  1. Of the 47 patients, there were 34 male and 13 female patients, and the mean age was 49 years.
  2. Causes of injury were traffic accidents(36 cases), falling down(7 cases), crushing injury(1 case), and others(3 cases), and the left side was more predominant(28 cases) than the right side (39 cases).
  3. Treatment modalities were conservative treatment(16 cases), Illizarov external fixators(8 cases), tibial bolt(11 cases) and screw & wire(12 cases).
  4. The range of motion of the knee joint averaged 116 degrees and the average start time of the range of motion exercise was 7.8 weeks. In the good to excellent clinical end results groups, there were meaningful statistical differences.
  5. There were statiscal differences between type I(88%), II(80%) fractures and type IV(56%), VI(33%) fractures for the clinical end results.
  6. We gained better results after treatment of closed fracture and isolated injury cases than open fracture or associated injury cases, but there were no statistical differences.
  7. There were no statistical differences on treatment modalities.

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