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The degree of fracture displacement does not affect the risk for concomitant proximal fibular fractures in tibial plateau fractures

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Abstract

Objective

The proximal fibula plays an important role in the knee joint; however, it has not been given enough attention by surgeons. This study aimed to investigate the risk factors for concomitant proximal fibular fractures in patients with tibial plateau fractures through computed tomography (CT) imaging.

Materials and Methods

From January 2016 to November 2017, patients who underwent percutaneous reduction and internal fixation (PRIF) for tibial plateau fractures at a level 1 trauma centre institute were included in this retrospective study. Full materials of CT imaging were obtained for measurements. Schatzker’s and a newly proposed classification system were used for the fracture of the tibial plateau and proximal fibula, respectively. Several clinical and radiological characteristics were recorded, and the impact of those variables on fibular fractures was assessed with univariate and multivariate analyses.

Results

In total, 174 patients were enrolled in the study with mean age of 45.6±13.1 years. The incidence of combined proximal fibular fracture was 38.3%. Schatzker type VI fracture had the highest rate of fibular fracture (77.4%). High-energy-pattern tibial plateau fractures (p=0.029) and posterolateral joint facet (PJF) involvements (p=0.002) are risk factors for proximal fibular fracture on multivariate analysis. Neither posterolateral column (PLC) involvements nor fracture displacement correlated with proximal fibular fractures.

Conclusions

Proximal fibular fractures were commonly seen among patients who sustained tibial plateau fractures. Schatzker type VI fractures had the highest rate of fibular fractures than other fracture types. High-energy fractures and PJF involvements correlated with a higher risk of proximal fibular fractures. A better understanding and awareness of the risk factors for proximal fibular fractures will provide surgeons with comprehensive understanding of tibial plateau fractures.

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Data Availability

All the data and material involving this article will be available upon request by sending an e-mail to the first author.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China

    Hengrui Chang & Zhanle Zheng

  2. Key laboratory of biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, China

    Hengrui Chang & Zhanle Zheng

  3. Musculoskeletal Tumor Center, Peking University People’s Hospital, Beijing, 100000, China

    Yiyang Yu

  4. Department of Orthopaedics, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, China

    Yingze Zhang

Authors
  1. Hengrui Chang
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  2. Zhanle Zheng
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  3. Yiyang Yu
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  4. Yingze Zhang
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Contributions

YYZ designed the study; HRC and ZLZ searched relevant studies; HRC and YYY analyzed and interpreted the data; HRC wrote the manuscript; and YZZ approved the final version of the manuscript.

Corresponding author

Correspondence to Yingze Zhang.

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Ethics approval

This study was approved by the Ethics Committee of the Third Hospital of Hebei Medical University (NO. KE 2016-001-1), and all subjects enrolled provided informed consent.

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Informed consent was obtained from all individual participants included in the study.

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Written informed consent for publication was obtained from all participants.

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The authors declare no competing interests.

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Chang, H., Zheng, Z., Yu, Y. et al. The degree of fracture displacement does not affect the risk for concomitant proximal fibular fractures in tibial plateau fractures. International Orthopaedics (SICOT) 45, 2963–2971 (2021). https://doi.org/10.1007/s00264-021-05034-0

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  • DOI: https://doi.org/10.1007/s00264-021-05034-0

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