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Determination of Posterior Tibial Slope Changes After Tibial Plateau Fracture Fixation: A Retrospective Case Series

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Abstract

Background and Aim

A tibial plateau fracture is an intra-articular fracture that affects the function and stability of the knee joint and requires careful evaluation and pre-operative planning. We determined the posterior tibial slope changes after tibial plateau fracture stabilization, aiming to help improve surgical success in maintaining the lower limb’s natural axis.

Methods

This retrospective case series involved all Golestan and Imam Khomeini hospital patients (Ahvaz, Iran) with Schatzker type IV–VI tibial plateau fractures from April 1, 2017, to March 30, 2020, who underwent surgical fixation. Data on the age, gender, body mass index (BMI), surgical approach, posterior tibial slope angle in the injured and healthy knees, pain, and knee joint instability were collected. We analyzed the data using SPSS version 22 and considered a significance level of P < 0.05.

Results

Among the 31 study participants, 24 (77.4%) were males. The mean age of the patients was 39.81 ± 14.41 years (21–78), with a mean BMI of 25.4 ± 2.7 (20.3–31.2) kg/m2 and hospitalization duration of 5.8 ± 9.3 days (3–29). Most patients had type VI fractures (48.3%). The posterior tibial slope angle shared no relation with age, gender, BMI, or surgical approach (P > 0.05). After tibial plateau fracture fixation, the posterior tibial slope angle significantly increased in the injured knee compared with the healthy knee (P < 0.05). Six months after the operation, the angle of the injured knee decreased but remained higher than that of the healthy knee (P > 0.05).

Conclusion

The tibial slope’s posterior column collapses more than its anterior column over time, reducing the posterior tibial slope angle. Therefore, the correct reduction of the tibial plateau’s posterior slope is more important.

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Data availability

Datasets and their analysis of the present study are available from the corresponding author on reasonable request.

References

  1. Hong, G., Huang, X., Lv, T., Li, X., et al. (2020). An analysis on the effect of the three-incision combined approach for complex fracture of tibial plateau involving the posterolateral tibial plateau. Journal of Orthopaedic Surgery and Research, 15(1), 43.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Albuquerque, R. P., Hara, R., Prado, J., Schiavo, L., Giordano, V., & do Amaral, N. P. (2013). Epidemiological study on tibial plateau fractures at a level I trauma center. Acta Ortopedica Brasileira, 21(2), 109–115.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Court-Brown, C. M., & McQueen, M. M. (2016). Global forum: Fractures in the elderly. Journal of Bone and Joint Surgery. American Volume, 98(9), e36.

    Article  PubMed  Google Scholar 

  4. Garner, M. R., Warner, S. J., & Lorich, D. G. (2016). Surgical approaches to posterolateral tibial plateau fractures. The Journal of Knee Surgery, 29(1), 12–20.

    PubMed  Google Scholar 

  5. Karimi, E., Norouzian, M., Birjandinejad, A., Zandi, R., & Makhmalbaf, H. (2017). Measurement of posterior tibial slope using magnetic resonance imaging. Archive of Bone and Joint Surgery, 5(6), 435–439.

    Google Scholar 

  6. Genin, P., Weill, G., & Julliard, R. (1993). The tibial slope. Proposal for a measurement method. Journal of Radiology, 74(1), 27–33.

    CAS  Google Scholar 

  7. Brandon, M. L., Haynes, P. T., Bonamo, J. R., Flynn, M. I., Barrett, G. R., & Sherman, M. F. (2006). The association between posterior-inferior tibial slope and anterior cruciate ligament insufficiency. Arthroscopy, 22(8), 894–899.

    Article  PubMed  Google Scholar 

  8. Zhang, Y., Wang, J., Xiao, J., et al. (2014). Measurement and comparison of tibial posterior slope angle in different methods based on three-dimensional reconstruction. The Knee, 21(3), 694–698.

    Article  PubMed  Google Scholar 

  9. Bae, D. K., Yoon, K. H., Song, S. J., Noh, J. H., & Kim, M. H. (2008). The change of the posterior tibial slope after cruciate retaining total knee arthroplasty. Journal of the Korean Orthopaedic Association, 43(2), 207–212.

    Article  Google Scholar 

  10. Erdil, M., Yildiz, F., Kuyucu, E., Sayar, Ş, Polat, G., et al. (2016). The effect of sagittal plane deformities after tibial plateau fractures to functions and instability of knee joint. Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca, 83(1), 43–46.

    Article  CAS  PubMed  Google Scholar 

  11. Streubel, P. N., Glasgow, D., Wong, A., Barei, D. P., Ricci, W. M., & Gardner, M. J. (2011). Sagittal plane deformity in bicondylar tibial plateau fractures. Journal of Orthopaedic Trauma, 25(9), 560–565.

    Article  PubMed  Google Scholar 

  12. Barei, D. P., Nork, S. E., Mills, W. J., Coles, C. P., et al. (2006). Functional outcomes of severe bicondylar tibial plateau fractures treated with dual incisions and medial and lateral plates. Journal of Bone and Joint Surgery-American Volume, 88(8), 1713–1721.

    Article  PubMed  Google Scholar 

  13. Gwinner, C., Weiler, A., & Plachel, F. (2021). Normalwerte—Wie bestimme ich den tibialen Slope richtig? Arthroskopie, 34, 10–13.

    Article  Google Scholar 

  14. Hoch, A., Jud, L., Roth, T., Vlachopoulos, L., et al. (2020). A real 3D measurement technique for the tibial slope: Differentiation between different articular surfaces and comparison to radiographic slope measurement. BMC Musculoskeletal Disorders, 26, 635.

    Article  Google Scholar 

  15. He, Q.-F., Sun, H., Shu, L.-Y., et al. (2018). Tibial plateau fractures in elderly people: An institutional retrospective study. Journal of Orthopaedic Surgery and Research, 13(1), 276.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Rademakers, M. V., Kerkhoffs, G. M. M. J., Sierevelt, I. N., Raaymakers, E. L. F. B., & Marti, R. K. (2007). Operative treatment of 109 tibial plateau fractures: Five- to 27-year follow-up results. Journal of Orthopaedic Trauma, 21(1), 5–10.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

This manuscript was revised regarding language, grammar, and writing quality by a native English-speaking language editor, Dr. Seyed Ali Hosseini (Native Editor Co., Iran).

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Authors and Affiliations

  1. Department of Orthopedics and Traumatology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Mohammad Fakoor, Payam Mohammadhoseini & Meghdad Variani

  2. Department of Radiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Mohammad Ghassem Hanafi

  3. Department of Biostatistics and Epidemiology, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Maryam Moradi

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  1. Mohammad Fakoor
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  2. Mohammad Ghassem Hanafi
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Correspondence to Meghdad Variani.

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Fakoor, M., Hanafi, M.G., Mohammadhoseini, P. et al. Determination of Posterior Tibial Slope Changes After Tibial Plateau Fracture Fixation: A Retrospective Case Series. JOIO 57, 1485–1489 (2023). https://doi.org/10.1007/s43465-023-00960-0

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