Osteosynthesis in Schatzker V and VI tibial plateau fractures in patients older than 65 years — one or two plates?

Abstract

Bicondylar tibial plateau fractures in elderly patients are rare. Indications for new locking precontoured plates with angular stability are increasing because of the powerful fixation in osteoporotic bone and possibility of percutaneous use. However, literature is lacking regarding these specific fractures.

To analyze the results of surgical management of bicondylar tibial plateau fractures (Schatzker classification types V and VI) in patients older than 65 years, comparing those treated with one locking plate and those with two plates.

19 patients were analyzed regarding these parameters: hemoglobin decrease, plates used, preoperative CT, loss of reduction or coronal alignment, time to consolidation, apparition of osteoarthritis, complications, visual analog scale and Oxford Knee Score (OKS).

Mean OKS was 36.8 (19–48), with 4 patients (21.05%) having excellent function and 13 (68.4%) moderate. There were only 2 wound infections and 2 varus collapses in the preoperative period. Eleven patients developed radiological osteoarthritis that was not present at the time of trauma.

Precontoured locking plates of bicondylar tibial plateau fractures in elderly patients provide mild to good function in approximately 90% of cases, although complications are observed in approximately 21% of patients.