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Approach variation affects outcomes after operative repair of lateral tibial plateau fractures

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

Abstract

Purpose

To determine if the type of approach used for treatment of lateral split-depression tibial plateau fractures affects clinical outcome and complications rate.

Methods

This is a retrospective review of 169 patients who presented between 01/2005 and 12/2020 to a Level-I trauma center for operative management of an isolated lateral Schatzker II tibial plateau fractures (AO/OTA Type 41B3.1) treated through a single anterolateral approach: a 90-degree “L” (L), longitudinal vertical (V), or “lazy S” (S). Postoperative radiographic, clinical, and functional outcomes were assessed at 3, 6, 12 months, and beyond.

Results

Average time to radiographic healing was longer in the S incision cohort (p < 0.05). Furthermore, patients within the S incision cohort developed more postoperative wound complications at follow-up when compared to those within the L and V incision cohorts (p < 0.05). Additionally, reoperation rates were greater in the S incision cohort (p < 0.05). Lastly, on physical examination of the knee, patients within the S incision cohort had significantly poorer knee range of motion (p < 0.05).

Conclusions

Our study demonstrates that skin incision type in the anterolateral approach to the proximal tibia has an association with outcomes following operative repair of tibial plateau fractures. The information from this study can be used to inform surgeons about the potential complications and long-term outcomes that patients may experience when undergoing operative repair of a tibial plateau fracture through a specific incision type.

Level of evidence

III.

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Acknowledgements

We would like to acknowledge Dr. Andrew Bi for his contributions to this manuscript.

Funding

This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, NYU Langone Medical Center, 301 E 17th Street, New York, NY, 10003, USA

    Alexa R. Deemer, Neha Jejurikar, Sanjit Konda, Philipp Leucht & Kenneth A. Egol

  2. Department of Orthopedic Surgery, Jamaica Hospital Medical Center, New York, NY, USA

    Sanjit Konda

Authors
  1. Alexa R. Deemer
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  2. Neha Jejurikar
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  3. Sanjit Konda
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  4. Philipp Leucht
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  5. Kenneth A. Egol
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Correspondence to Kenneth A. Egol.

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Deemer, A.R., Jejurikar, N., Konda, S. et al. Approach variation affects outcomes after operative repair of lateral tibial plateau fractures. Eur J Orthop Surg Traumatol 33, 1705–1711 (2023). https://doi.org/10.1007/s00590-022-03343-7

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  • DOI: https://doi.org/10.1007/s00590-022-03343-7

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