Short-term clinical outcome of not-fixed posterolateral fragment for tibial plateau fractures

Tibial plateau fractures pose multiple challenges to the surgeon given their frequent intra-articular involvement and the tendency to displace under axial load. The aim of this study is to de-scribe the clinical outcomes of a retrospective case series in which tibial plateau fractures were not treated with PL fragment osteosynthesis.

In the present retrospective study, we included patients treated for tibial plateau fracture with PL fragment in our department from January 2016 to January 2020. All patients were seen at the outpa-tient clinic 2 and 5 weeks after surgery, and at 3, 6 and 12 months, and thereafter at regular intervals, depending on the overall clinical status. Every patient included in this study was then contacted by phone to assess self-reported clinical outcomes. The Oxford Knee Score (OKS) questionnaire was used to assess functional outcomes. Patients were divided in six groups depending on the three-column classification by Lou (groups A1-A6). Patients were also divided in four groups based on the whole area of the PL column and on the depression of the PL fragment (group B1-B4). One-way ANOVA was used to compare groups of patients.

OKS scores, extension and step-off of the PL fragment were analyzed in groups A1 - A6. No significant differences between OKS scores and step-off were found, while statistical difference was found between surfaces of PL fragment. No significant difference was found between OKS scores in groups B1-B4.

Our findings suggest that the treatment outcome is influenced not only by the superficial involvement or collapse of PL fragments, but also by other variables, including BMI, pre-injury physi-cal health, and age.