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High-energy tibial plateau fractures: external fixation versus plate fixation

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Objective

Whether external or plating fixation is more appropriate for high-energy tibial plateau fractures is still being disputed, our aim was to test the hypothesis whether external fixation can provide a fair outcome with fewer complications, when compared to the results with previously reported data of plating fixation for high-energy tibial plateau fractures.

Methods

An Ovid of Medline, Embase, and Cochrane Library search was conducted for the relevant English orthopedic journals, and eligible studies, including twenty-four case series and one comparative study containing 885 patients associated with 892 fractures, were enrolled.

Results

The results showed there were a higher proportion of men, open fractures, malunion, knee instability, and posttraumatic arthritis occurred in external fixation group than those in plating group (P = 0.007, P = 0.000, P = 0.024, P = 0.006, P = 0.000, respectively), while valgus deformity happened at a significantly higher rate in plate group (P = 0.014). No significant differences were found between the two groups in terms of age, Schatzker type, follow-up, mean time to union, mean range of knee motion, and rate of reoperation. With regard to the functional and radiological outcome assessment, despite what assessment tools were used, most of these studies presented less than 90 % good/excellent results in their high-energy fracture series. Besides, there was a trend for patients in plating group to have a higher risk than those in external fixation group in terms of heterotopic ossification and local irritation (1.23 vs 0.17 %, 4 vs 1.94 %, accordingly).

Conclusions

Although lack of good quality randomized control trials, there are rather enough samples supporting the current available results. Meanwhile, future multicentered, randomized, controlled studies should be implemented to test these outcomes.

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Conflict of interest

All the authors declared that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopedics, Panzhihua City Central Hospital, Panzhihua, No. 34 on the Street of Yi kang, East Area of Panzhihua City, Province Sichuan, China

    Liang Yu & Zhong Fenglin

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  1. Liang Yu
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  2. Zhong Fenglin
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Correspondence to Zhong Fenglin.

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Yu, L., Fenglin, Z. High-energy tibial plateau fractures: external fixation versus plate fixation. Eur J Orthop Surg Traumatol 25, 411–423 (2015). https://doi.org/10.1007/s00590-014-1528-7

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  • DOI: https://doi.org/10.1007/s00590-014-1528-7

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