Outcomes of tibial plateau fractures in Chris Hani Baragwanath Academic Hospital: A retrospective review

Background: Peri-articular injuries to the proximal tibia are difficult to manage. Various treatment modalities have been used with mixed results. Objective: The aim of this study was to report on short-term outcomes of patients treated for tibial plateau fractures at a South African tertiary hospital. Methods: This was a retrospective study conducted from January 2018 to December 2020. This study aimed to evaluate short-term outcomes with a required minimum follow-up of 18 months. Results: Forty-six patients (23 males and 23 females) met the inclusion criteria. Twelve (26.09%) patients developed early complications within 6 weeks following surgery while 5/46 (10.87%) developed late complications. Four of the 5 patients that had late complications also had early complications. Two (4.35%) patients had prominent hardware, 7/46 (15%) met the suggestive criteria for Fracture-Related Infection (FRI), 2/46 (4.35%) met the confirmatory criteria for FRI, 3/46 (6.52%) developed knee stiffness and 1/46 (2.17%) had Loss of Reduction (LOR). Five patients (11.87%) could not be fitted into any criteria for FRI as record charts were inadequate and only labelled these as Surgical Site Infection (SSI). The mean pain VAS was 2.7 (SD: 2.1). When reviewing the post-operative Range of Motion (ROM), the average knee extension was 8.910 (range 00 – 350) and 109.240 (range 700 – 1300) for flexion. Conclusion: The short-term outcomes of treatment of tibial plateau fractures is favourable but could be improved. Bicolumnar fixation is associated with early complications compared to the anterolateral approach. With appropriate time interval from injury to definitive surgery, the rate of FRI after ORIF is low.