Authors' conclusions: REHABILITATION GUIDELINES: TIBIAL PLATEAU FRACTURE OPEN REDUCTION INTERNAL FIXATION STAGE 1 (Day 1 - 4 weeks): ROM: ASK SURGEON: hinged brace locked in … Results (66 participants) for quality of life scores using the 36-item Short Form Health Survey (SF-36)), Hospital for Special Surgery (HSS) scores and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function scores tended to favour hybrid fixation, but a benefit of ORIF could not be ruled out. Introduction Tibial plateau fracture is a kind of the intra-articular fractures, and its methods of treatments and outcomes are different due to different causes of injury and different types of fractures (Dirschl & Dawson, 2004). Type II tibial condyle fracture involving the tibial spine and more than 50% of the medial condyle fixed with biological buttress plating of the lateral plateau. This allows for easy access to an anterolateral approach or combined anterolateral and posteromedial approaches. Primary total knee arthroplasty (TKA) may be of benefit in elderly patients with a combination of osteoporotic bone and metaphyseal comminution. (c) Meniscus with stay sutures to aid in repair of peripheral meniscus following open reduction and internal fixation (ORIF) of the tibial plateau using a submeniscal arthrotomy. There was very low quality evidence of higher HSS knee scores and higher knee range of motion values in the arthroscopically assisted group. Data collection and analysis: Design: Mail survey and literature review were used to define the fixation failure; this definition was applied to a radiologic review of patients who were treated surgically for tibial plateau fracture at a Level 1 trauma unit for a three-year period from 1993 to 1995. Objectives: Risk factors include osteoporosis and certain sports such as skiing. the split fragment. doi: 10.1002/14651858.CD010606.pub2. Type VI tibial plateau fracture undergoing biological fixation of the lateral condyle and external fixation of the medial plateau, resulting in an acceptable clinical and radiological result. Tibial plateau fractures result from high energy, blunt force trauma and are associated with severe bone and soft-tissue injury. Surgical fixation is usually used for more complex tibial plateau fractures. 2006 Dec;88(12):2613-23. doi: 10.2106/JBJS.E.01416. injuries associated with these fractures. The trial provided no evidence of differences in HSS knee scores, complications or reoperation entailing implant removal or revision fixation. We accept that our study has some limitations. J Bone Joint Surg Br 1981; 63B(4): 575 – 578. Therefore, a careful Hua K, Jiang X, Zha Y, Chen C, Zhang B, Mao Y. J Orthop Surg Res. Studies have described outcomes of arthroscopic-assisted percutaneous fixation (AAPF) of these injuries but have rarely reported postoperative activity levels. The tibial plateau fracture and the tibial pilon fracture require accurate open reduction and fixation. contemplating percutaneous fixation. Closed treatment of a tibial plateau fracture is indicated when the fractured segments are stable, in good alignment, and the tibial joint surface is congruent. The incidences of individual complications were similar between groups in all three trials. Results of the two groups were comparable for the WOMAC pain subscale and stiffness scores, but mean knee range of motion values were higher in the hybrid group.Another trial compared the use of a minimally invasive plate (LISS system) versus double-plating ORIF in 84 people who had open or closed bicondylar tibial plateau fractures. Accept Diagnosis is typically suspected based on symptoms and Surgical fixation is usually used for more complex tibial plateau fractures. Patient Immediate internal fixation of open, complex tibial plateau fractures: treatment by a standard protocol. surgically for tibial plateau fracture at a Level 1 trauma unit for a three-year period from 1993 to 1995. wires (K-wires) is performed (Fig. Aug 28, 2020 - Explore Heather Newman's board "Tibial plateau fracture", followed by 157 people on Pinterest. Further well-designed, larger randomised trials are warranted. straight or hockey stick incision anterolaterally from just proximal to joint line to just lateral to the tibial tubercle midline incision (if planning TKA in future) can lead … Limited Internal Fixation of Tibial Plateau Fractures. Regular manual treatment should be conducted to the patella and all incisions--with particular attention to the anterior medial portal--to decrease the incidence of fibrosis. An arthroscope from the anterolateral portal is used to further visualize the subchondral surface. Tibial plateau fractures with a significant open component and contamination will commonly be treated with external fixation for stabilization with … The arthrotomy can be submeniscal (, Once elevated, provisional stabilization of the articular fragments to the medial or lateral condyle using Kirschner, Once satisfied with the fracture reduction, definitive, After definitive fracture stabilization, the incision is, Postoperatively, the knee should be protected in a. Use of arthroscopic-assisted internal fixation to reduce a tibial plateau fracture of the right knee. Open reduction and internal fixation of tibial plateau fracture. doi: 10.7759/cureus.11066. doi: 10.1002/14651858.CD009651.pub2. If the fracture is non-displaced, or if a Standard of Care: Tibial Plateau Fracture 1 Clipboard, Search History, and several other advanced features are temporarily unavailable. Wound closure may then be performed at a later date. Epub 2019 Nov 22. People are generally unable to walk. Google Scholar | Crossref | Medline. Early detection and appropriate treatment of tibial plateau fractures are critical for minimising damage to the knee and reducing the risk of further complications such as osteoarthritis.. Please enable it to take advantage of the complete set of features! Arthroscopic reduction and fixation of tibia plateau fractures are described in the literature.11, 12 The differences are that they use anterior portals and talk about tibial plateau depressed fractures like Schatzker type II and III. Orthobullets Team % TECHNIQUE VIDEO 0 % TECHNIQUE STEPS 0. [1] Symptoms include pain, swelling, and a decreased ability to move the knee. Quality of life, pain and return to pre-injury activity were not reported. 2018 Mar;32(3):141-147. doi: 10.1097/BOT.0000000000001042. J Bone Joint Surg Am. A tibial plateau fracture is a break of the upper part of the tibia that involves the knee joint. F. Flandry 15:24 California Orthopaedic Association High Energy Tibial Plateau Fractures Feat. Obtains focused history and performs focused exam . 1. J Bone Joint Surg Am. doi: 10.7759/cureus.4902. The cause is typically trauma such as a fall or motor vehicle collision. 2Faculty of Medicine and Biz C, Maso G, Gambato M, Belluzzi E, Pozzuoli A, Favero M, Vigo M, Ruggieri P. Orthop Surg. - Meniscal detachment to approach lateral tibial plateau fractures. 30-15). Fixation of bicondylar tibial plateau fractures via a single anterior mid-line incision is now generally avoided owing to extensive soft tissue dissection required and the consequential wound problems associated with this approach. May progress to one crutch at 71/2 weeks as tolerated, gradually wean off of crutches by week 8 … XXIX, N 3, 364-368 DE CLÍNICA PSICOLÓGICA reduction and internal fixation methods and whether to perform bone graft. Google Scholar | Crossref | Medline. The Global Burden of Surgical Management of Osteoporotic Fractures. 0. 27.3). Only very limited pooling, using the fixed-effect model, was possible. See more ideas about Tibial plateau fracture, Fracture, Plateau. To review available approaches and fixation methods for posterolateral fracture fragment (PLF) in tibial plateau fracture, and to propose an algorithm to treat various types of plateau fractures which all involve the PLF. The outcome of bicondylar tibial plateau fractures treated with either external fixation (35 patients) or internal fixation (24 patients) was reviewed. COVID-19 is an emerging, rapidly evolving situation. Patients and SettingForty-two consecutive patients treated surgically at our trauma unit for tibial plateau fractures were studied retrospectively, specifically for loss of fixation. 2019 Jun 14;11(6):e4902. Tibial plateau fractures are a common orthopedic injury. However, all 38 participants in the autologous iliac bone graft group of one trial reported prolonged pain from the harvest site. Cureus. Quality of life, pain, knee range of motion and return to pre-injury activity were not reported. © 2020 - TeachMe Orthopedics. Arthroscopic-assisted internal fixation is an ideal technique for visualizing chondral reduction during tibial open reduction–internal fixation. Posteromedial and anterolateral tibia approach To review functional outcome in high energy tibial plateau fractures treated by plating. Open reduction and internal fixation were considered to be the best mechanical method of stabilization for bicondylar tibial plateau fractures. It is prone to becoming fractured in high-speed accidents such as those associated with skiing, horse riding, and certain water sports. Tibial Plateau Fracture External Fixation. Important landmarks around the proximal tibia include the tibial tubercle, Gerdy′s tubercle, the pes … In these cases, TEF also allows the restoration of metaphyseal-diaphyseal dissociation ( Fig. The Effect of Soft Tissue Injuries on Clinical Outcomes After Tibial Plateau Fracture Fixation. [2] Complication may include injury to the artery or nerve, arthritis, and compartment syndrome. The most common contraindication to emergent internal fixation of a tibial plateau fracture is a compromised soft-tissue envelope, which can occur in either open or closed fractures. Hall JA, Beuerlein MJ, McKee MD; Canadian Orthopaedic Trauma Society. We judged the quality of most of the available evidence to be very low, meaning that we are very uncertain about these results.One trial compared the use of a circular fixator combined with insertion of percutaneous screws (hybrid fixation) versus standard open reduction and internal fixation (ORIF) in people with open or closed Schatzker types V or VI tibial plateau fractures. Open reduction and internal fixation compared with circular fixator application for bicondylar tibial plateau fractures. These studies are an excellent adjunct to plain x-ray films in the Currently there is no consensus on either the best method of fixation or bone void filler. Complication may include injury to the artery or nerve, arthritis, and compartment syndrome. Injuries to other structures about the knee are commonly associated with tibial plateau fractures. Type II tibial condyle fracture involving the tibial spine and more than 50% of the medial condyle fixed with biological buttress plating of the lateral plateau. Participants in the hybrid fixation group had a lower risk for an unplanned reoperation (351 per 1000 people compared with 450 in the ORIF group; 95% CI 197 fewer to 144 more) and were more likely to have returned to their pre-injury activity level (303 per 1000 people, compared with 121 in the ORIF group; 95% CI 15 fewer to 748 more). 2020 Oct 20;12(10):e11066. Following resolution of the soft-tissue injury, definitive fracture surgery can be undertaken with the expectation of fewer complications (Fig. Fixation is performed with cannulated screws (Arthrex) being drilled in over the K-wires and then tightened by hand (Fig 4). 1, April 2012 Closed reduction and percutaneous screw fixation for tibial plateau fractures 39 unless there was articular depression. Rangitsch MR , et al. Achieving those outcomes starts with a thorough evaluation and preoperative planning period, which leads to choosing the most appropriate surgical approach and fixation strategy. 7. At this point, the metaphyseal defect should be The use of the brace could vary from 10 days to 6 weeks. Tibial Plateau Fractures. 1. It is a serious type of knee injury that can affect all types of men and women athletes. All six trials were small and at substantial risk of bias. The incidence of tibial plateau fractures is 10.3 per 100,000 annually; they are often connected to motor vehicle accidents. 2019 Dec;11(6):1149-1162. doi: 10.1111/os.12577. More recently, Lobenhoffer et al 10 in 2004 described a limited posterior approach for tibial plateau fracture fixation that has been popularized by subsequent authors that uses the medial aspect and dissection of the extensile approach for the treatment of posteromedial tibial plateau fractures. External fixation, ORIF or TKA are the different appropriate procedures in complex bicondylar tibial plateau fractures (Schatzker V and VI), depending on the state of soft tissues, pattern of fracture, age, comorbidities, bone stock, patient compliance and severe pre-existing OA. Lateral Tibial Plateau Fracture: Open Reduction and Internal Fixation By admin Last updated Apr 26, 2020 Tibial plateau fractures result from indirect coronal and from direct axial compressive forces. to realign the fractured segments. Fixation of bicondylar tibial plateau fractures via a single anterior mid-line incision is now generally avoided owing to extensive soft tissue dissection required and the consequential wound problems associated with this approach. NLM Key words: Fracture; Tibia plateau; Internal fixation; Bone graft 1. Additionally, bone void fillers are often used to address bone defects caused by the injury. Interventions for treating fractures of the distal femur in adults. Unusual Good Functional Outcome After Surgical Management of Maluniting Schatzker Type II Fracture. (Fig. Type VI tibial plateau fracture undergoing biological fixation of the lateral condyle and external fixation of the medial plateau, resulting in an acceptable clinical and radiological result. Meniscus tears as well as injuries to the articular cartilage commonly occur i… doi: 10.1002/14651858.CD000434.pub4. Tibial Plateau Fracture Treatment Options Fracture of the tibial plateau affects knee alignment, stability and movement. The immobilisation after the fixation of the tibial plateau fractures applies only to the internal fixation surgical option and includes the use of a hinged knee brace. Additionally, bone void fillers are often used to address bone defects caused by the injury. The physician may need to perform a manual reduction in 27532 to realign the fractured segments. Injury 2010; 41(11): 1178 – 1182. A. Outpatient Management. Hence, fractures of the tibial plateau are often associated with injuries to the anterior cr… The rationale of operative fracture care. Fractures of the tibial plateau, which are intra-articular injuries of the knee joint, are often difficult to treat and have a high complication rate, including early-onset osteoarthritis. Schatzker 3 fractures of the lateral tibial plateau, in which Background: Tibial plateau fractures: internal fixation with locking plates and the MIPO technique. No reoperations were reported.Three trials compared different types of bone substitute versus autologous bone graft (autograft) for managing bone defects. The mechanism of this fracture is a combination of valgus … J Orthop Trauma. We believe that the occurrence of complications could be effectively prevented by careful operation during surgery, protection of the surrounding soft tissue, prevention of damage to the patellar tendon, and good reduction and fixation of the tibial tubercle. The tibial plateau is one of the most critical load-bearing areas in the human body. Surgical fixation is usually used for more complex tibial plateau fractures. We calculated risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, with 95% confidence intervals (CIs). Tibial plateau fractures are complex injuries of the knee. Material and Methods. 2019 Aug 23;14(1):267. doi: 10.1186/s13018-019-1321-8. Due to the tibial plateau’s proximity to important vascular (i.e., arteries, veins) and neurological (i.e., nerves such as peroneal and tibial) structures, injuries to these nerves may occur upon tibial plateau fracture. Scotland, T, Wardlaw, D. The use of cast-bracing as treatment for fractures of the tibial plateau. Scapula Fractures: Open Reduction Internal Fixation, Biomalleolar Ankle Fractures: Open Reduction and Internal…, Aspiration and Injection of Upper and Lower Extremities, Forearm Fractures: Open Reduction Internal Fixation, General Outline of the Neurologic Examination, Fibrous Cortical Defect/Nonossifying Fibroma, Testing Orientation, Concentration, Knowledge, and Constructional Ability, Chronic Massive Rotator Cuff Tears: Evaluation and…, Thoracic Spondylosis, Stenosis, and DISC Herniations, This website uses cookies to improve your experience. - The use of an anterior incision of the meniscus for exposure of tibial plateau fractures requiring open reduction and internal fixation. Cochrane Database Syst Rev. Vol. The patient is placed in the supine position with his right leg propped using an OSI leg holder. Two trials reported similar range of motion results in the two groups, whereas the third trial favoured the bone substitute group. Magnetic resonance imaging may fired distal and parallel to the tibial plateau. Two review authors independently screened search results, selected studies, extracted data and assessed risk of bias. Symptoms include pain, swelling, and a decreased ability to move the knee. If the wound cannot be closed without tension, it is. Posterolateral tibial plateau fractures account for about 8–15% of all tibial plateau fractures. Preoperative Patient Care. Currently there is … Tibial plateau fractures result from high energy, blunt force trauma and are associated with severe bone and soft-tissue injury. Three trials evaluated different types of fixation and three analysed different types of bone graft substitutes. Open reduction refers to open surgery to realign the bonesand internal fixation refers to fixation of screws and/or plates to hold the affected bones in place and to help support the fracture. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Read More, Copyright ©2004 Lippincott Williams & Wilkins, Lateral Tibial Plateau Fracture: Open Reduction and Internal Fixation, Tibial plateau fractures result from indirect coronal, The tibial plateau is composed of medial and lateral articular surfaces (, The most widely accepted classification has been that proposed by Schatzker (, Controversy exists regarding the specific indications, Initial radiographs should include an anteroposterior, a lateral, and two oblique views and the 15-degree caudal plateau view (, Comparison radiographs of the contralateral extremity, The exact nature of the fracture should be understood before attempting any form of surgical intervention (, Several basic instruments are necessary for open reduction and internal fixation of a tibial plateau fracture (, Large- and small-diameter cannulated screws, Femoral distractor with or without an external fixator set, PATIENT POSITIONING AND FRACTURE REDUCTION, Patients should be positioned supine with a bolster, Fracture reduction can be aided by the use of, After the level of the capsule has been reached, an arthrotomy is performed.  |  preoperative planning for lag screw placement, particularly when HHS Interventions for treating proximal humeral fractures in adults. Tibial plateau fractures may result in significant limitations postoperatively. Surgical treatment of a displaced tibial plateau fracture usually involves open reduction and internal fixation (ORIF) of the tibial plateau fracture. Fixation Philosophy in Tibial Plateau Fractures Feat. This video shows a two incision surgical approach with would be used to treat a bicondylar tibial plateau. Orthopedic management of tibial plateau fractures varies from conservative non-operative treatment to open reduction and internal fixation (ORIF). However, reduction without visualization does not ensure chondral surface … Various methods of percutaneous fixation of tibial plateau fractures are available.  |  Our primary outcomes were quality of life measures, patient-reported outcome measures of lower limb function and serious adverse events. Interventions for treating fractures of the patella in adults. Tibial plateau fractures present in a wide spectrum of injury severity and pattern, each requiring a different approach and strategy to achieve good clinical outcomes. This site needs JavaScript to work properly. Nearly twice as many participants (22 versus 12) in the ORIF group had a bone graft. 8. Early detection and appropriate treatment of these fractures are essential in minimizing patient's disability in range of movement, stability and reducing the risk of documented complications.The fractures are classified according the Schatzker classification system. Surgery requires putting the bones back together with what are known in the medical trade as “Fixation techniques.” These require considerable surgical skill and experience. The tibial plateau is the upper surface of the tibia or shin bone. by 12 weeks based on radiographic evidence of consolidation. TECHNIQUE STEPS. Although percutaneous fixation of tibial plateau fractures is still in its infancy, it is expected to develop rapidly because the method seems to avoid major soft tissue complications and shortens the length of the patient's stay in the Plateau fractures can range from low energy injuries with little or no displacement to complex fractures with significant associated injuries. 30-4). A bump is placed under the hip to neutralize extremity rotation, and the leg is elevated with a nonsterile radiolucent platform or a sterile bump after draping. We'll assume you're ok with this, but you can opt-out if you wish. 2015 Aug 13;(8):CD010606. Retrospective analysis. Begin partial weight bearing at 25% of body weight and increase by 25% approximately every 3 days. To assess the effects (benefits and harms) of different surgical interventions, and the use of bone void fillers, for treating tibial plateau fractures. Side plate and multiple screws used to hold fracture fragments together. (OBQ06.245) A 35-year-old male sustains a closed Schatzker VI tibial plateau fracture. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (12 September 2014), the Cochrane Central Register of Controlled Trials (2014 Issue 8), MEDLINE (1946 to September Week 1 2014), EMBASE (1974 to 2014 Week 36), trial registries (4 July 2014), conference proceedings and grey literature (4 July 2014). bone grafted and the split fragment reduced and provisionally stabilized (Fig. For fixation of tibial plateau fractures, the patient is most commonly positioned supine. 2015 Nov 11;(11):CD000434. Readers will also find of interest Sleeved Total Knee Replacement for Tibial Plateau Fracture (MBT DePuy) NIH For Preview Only [Intervention Review] Surgical fixation methods for tibial plateau fractures Iain R McNamara1, Toby O Smith 2, Karen L Shepherd1, Allan B Clark , Dominic M Nielsen3, Simon Donell2, Caroline B Hing3 1Department of Trauma and Orthopaedics, Norfolk and Norwich University NHS Trust, Norwich, UK. Patients and SettingForty-two consecutive patients treated surgically at our trauma unit for tibial plateau fractures were studied retrospectively, specifically for loss of fixation. Fractures of the tibial plateau are considered quite serious as this upper surface of the bone contains structures which are critical to the knees functioning. We included six trials in the review, with a total of 429 adult participants, the majority of whom were male (63%). Comparison of Postoperative Outcomes Between Open Reduction and Internal Fixation and Ilizarov for Schatzker Type V and Type VI Fractures. 2015 Feb 27;(2):CD009651. In addition to severe soft tissue trauma, temporary external fixation (TEF) finds appropriate use in axially unstable tibial plateau compound fractures as Schatzker type V an VI. Typically, open reduction–internal fixation is performed using radiographic and Fluoroscan imaging (Hologic, Bedford, MA) for reduction of subchondral bone. Main results: Griffin XL, Parsons N, Zbaeda MM, McArthur J. Cochrane Database Syst Rev. Open reduction and internal fixation compared with circular fixator application for bicondylar tibial plateau fractures. These K-wires should be placed to avoid interfering with reduction of USA.gov. preferable to leave the incision partially open and covered with a A tibial plateau fracture is a break of the upper part of the tibia (shinbone) that involves the knee joint. 4 ) and may be associated with minimal open reduction and percutaneous screw fixation. 30-16). A tibial plateau fracture is a fracture involving the proximal (upper) portion of the tibia which extends through the articular surface (into the knee joint). 1 Tibial plateau fractures are categorized by a combination of physical and radiographic examination findings. 20 No. Cureus. [1] People are generally unable to walk. Surgical fixation of tibial plateau fracture in elderly patients with open reduction and internal fixation (ORIF) provides inferior outcomes compared with younger patients. A quasi-randomised trial comparing arthroscopically-assisted percutaneous reduction and internal fixation versus standard ORIF reported results at 14 months in 58 people with closed Schatzker types II or III tibial plateau fracture. Retrospective analysis of 514 cases of tibial plateau fractures based on morphology and injury mechanism. One trial found no cases of inflammatory response in the 20 participants receiving bone substitute, and two found no complications associated with the donor site in the autograft group (58 participants). Operative management is typically warranted in complicated tibial plateau fractures*, or any evidence of open fracture or compartment syndrome. These fractures involve the articular surface of the tibia that is part of the knee joint. Plating with Indirect reduction Dewilius PJ, Rangitsch MR, Colville MR, et al. Sayum Filho J, Lenza M, Teixeira de Carvalho R, Pires OG, Cohen M, Belloti JC. sterile dressing. fixation • Axially unstable tibial plateau fracture –Bicondylar fracture –Schatzker type V and VI • Fracture / Dislocation –Schatzker type IV. For Preview Only [Intervention Review] Surgical fixation methods for tibial plateau fractures Iain R McNamara1, Toby O Smith 2, Karen L Shepherd1, Allan B Clark , Dominic M Nielsen3, Simon Donell2, Caroline B Hing3 1Department of Trauma and Orthopaedics, Norfolk and Norwich University NHS Trust, Norwich, UK. Search methods: Surgical technique. Objective. However, the evidence does not contradict approaches aiming to limit soft-tissue dissection and damage or to avoid autograft donor site complications through using bone substitutes. Sixty-five patients with Schatzker type V and type VI tibial plateau fractures treated with open reduction and internal fixation using plates were included in the study. We included randomised and quasi-randomised controlled clinical trials comparing surgical interventions for treating tibial plateau fractures and the different types of filler for filling bone defects. Quality of life, pain and return to pre-injury activity were not reported. Design. A mini C-arm is used to view the lateral tibial plateau fracture in the right knee. REVISTA ARGENTINA 2020, Vol. Additionally, bone void fillers are often used to address bone defects caused by the injury. World J Surg. The surgeon should select that plate that offers stable fixation but minimizes bulk to prevent complications with wound closure. 2009 Mar 1;91 Suppl 2 Pt 1:74-88. doi: 10.2106/JBJS.G.01165. It divides tibial plateau fractur… The optimal method of fixation is dictated by soft tissue injury, fracture characteristics, and functional demands of the patient. Any form of medial tibial plateau fractures may also require surgical intervention, even if undisplaced, as they have a great potential for displacement.  |  All Rights Reserved. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Patients treated surgically at our trauma unit for tibial plateau fractures result from high energy, blunt force trauma are... Tive fixation methods, should be considered in patients in whom load is expected to be out with normal range... Be considered in patients in whom load is expected to be the best method of is! Fractures treated by plating People are generally unable to walk Osteoporotic fractures the incidence of tibial plateau is... Knee alignment, stability and movement 38 participants in the right knee used... Level 1 trauma unit for tibial plateau fractures: treatment by a combination of physical and radiographic findings! 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J Orthop Surg..: CD009651 about tibial plateau fracture at a later date plating is almost always necessary support. ( Arthrex ) being drilled in over the K-wires and then tightened by hand ( Fig 4 ) void. However, all 38 participants in the right knee groups, whereas the third trial favoured bone. Association high energy tibial plateau fractures were studied retrospectively, specifically for of!