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Changing patterns in the epidemiology of tibial plateau fractures: a 10-year review at a level-I trauma center

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Mobility patterns of western societies have been changing due to ongoing demographic change. Therefore, continuously updated epidemiological data on fracture morphology and treatment strategies are needed.

Methods

This retrospective single-center study included all tibial plateau fractures (TPF) between January 2011 and December 2020 in a level-I trauma center in Central Europe. Epidemiology, trauma mechanism and fracture morphology were analyzed. Age- and sex-specific differences regarding fracture classification (Schatzker, AO/OTA, Moore) and changes during the study period are highlighted.

Results

A total of 607 patients (55.2% women, 44.8% men, mean age 52.9 years (± 17.9)) were included in the study, 462 (76.1%) thereof having undergone surgical treatment. Over the decade, an increase in mean age (+ 7.4 years; p = 0.10), incidence (+ 68%; p < 0.05) and low-energy trauma was observed, with the highest peak in elderly women. Within classifications, AO/OTA 41-B3 (24.9%), Schatzker II (26.8%) and Moore V (46.6%) fractures were the most common.

Conclusion

Incidence (+ 68%), mean age and fractures with signs of knee dislocation of tibial plateau fracture increased over the last decade and low-energy trauma mechanism are more frequent. As the increase in incidence is mainly seen in older women, the comorbidities and need for immediate postoperative full weight-bearing have to be considered in treatment strategies.

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References

  1. Rapp K, Büchele G, Dreinhöfer K, Bücking B, Becker C, Benzinger P. Epidemiology of hip fractures : systematic literature review of german data and an overview of the international literature. Z Gerontol Geriatr. 2019;52:10–6.

    Article  PubMed  Google Scholar 

  2. Hagen G, Magnussen J, Tell G, Omsland T. Estimating the future burden of hip fractures in Norway. NOREPOS Study Bone. 2020;131:115156.

    Article  PubMed  Google Scholar 

  3. Rundgren J, Bojan A, Mellstrand Navarro C, Enocson A. Epidemiology, classification, treatment and mortality of distal radius fractures in adults: an observational study of 23,394 fractures from the national swedish fracture register. BMC Musculoskelet Disord. 2020;21:88.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Hernandez RK, Do TP, Critchlow CW, Dent RE, Jick SS. Patient-related risk factors for fracture-healing complications in the United Kingdom general practice research database. Acta Orthop. 2012;83:653–60.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Pfeufer D, Grabmann C, Mehaffey S, Keppler A, Böcker W, Kammerlander C, et al. Weight bearing in patients with femoral neck fractures compared to pertrochanteric fractures: a postoperative gait analysis. Injury. 2019;50:1324–8.

    Article  PubMed  Google Scholar 

  6. Sabatini L, Aprato A, Camazzola D, Bistolfi A, Capella M, Massè A. Primary total knee arthroplasty in tibial plateau fractures: literature review and our institutional experience. Injury. 2021;S0020–1383(21):00104–12.

    Google Scholar 

  7. Elsoe R, Larsen P, Nielsen NPH, Swenne J, Rasmussen S, Ostgaard SE. Population-based epidemiology of tibial plateau fractures. Orthopedics. 2015;38:e780–6.

    Article  PubMed  Google Scholar 

  8. Oladeji LO, Worley JR, Crist BD. Age-related variances in patients with tibial plateau fractures. J Knee Surg. 2020;33:611–5.

    Article  PubMed  Google Scholar 

  9. Wennergren D, Bergdahl C, Ekelund J, Juto H, Sundfeldt M, Möller M. Epidemiology and incidence of tibia fractures in the swedish fracture register. Injury. 2018;49:2068–74.

    Article  PubMed  Google Scholar 

  10. Rupp M, Walter N, Pfeifer C, Lang S, Kerschbaum M, Krutsch W, et al. The incidence of fractures among the adult population of germany–an analysis from 2009 through 2019. Dtsch Arztebl Int. 2021;118:665–9.

    PubMed  PubMed Central  Google Scholar 

  11. Krause M, Preiss A, Müller G, Madert J, Fehske K, Neumann MV, et al. Intra-articular tibial plateau fracture characteristics according to the “ten segment classification.” Injury. 2016;47:2551–7.

    Article  PubMed  Google Scholar 

  12. Borgström F, Karlsson L, Ortsäter G, Norton N, Halbout P, Cooper C, et al. Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos. 2020;15:59.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Decruz J, Antony Rex RP, Khan SA. Epidemiology of inpatient tibia fractures in Singapore—a single centre experience. Chin J Traumatol. 2019;22:99–102.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Hua K, Jiang X, Zha Y, Chen C, Zhang B, Mao Y. Retrospective analysis of 514 cases of tibial plateau fractures based on morphology and injury mechanism. J Orthop Surg Res. 2019;14:267.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Yao X, Xu Y, Yuan J, Lv B, Fu X, Wang L, et al. Classification of tibia plateau fracture according to the “four-column and nine-segment.” Injury. 2018;49:2275–83.

    Article  PubMed  Google Scholar 

  16. Hissnauer T-N, Krause M, Frings J, Frosch K-H. Chirurgische Zugänge zum Tibiakopf. OP-JOURNAL Georg Thieme Verlag KG. 2019;34:107–16.

    Google Scholar 

  17. Schatzker J, Mcbroom R, Bruce D. The tibial plateau fracture: the toronto experience 1968–1975. Clin Orthop Rel Res. 1979;138:94–104.

    Google Scholar 

  18. Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, et al. Fracture and dislocation classification compendium - 2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma. 2007;21:S1-133.

    Article  CAS  PubMed  Google Scholar 

  19. Moore TM. Fracture dislocation of the knee. Clin Orthop Relat Res. 1981;156:128–40.

    Article  Google Scholar 

  20. Alvi F, Charalambous CP, Tryfonidis M, Samarji R, Hirst P. Inter- and intra-observer variation of the Schatzker and AO/OTA classifications of tibial plateau fractures and a proposal of a new classification system. Injury Extra. 2008;5:178.

    Article  Google Scholar 

  21. Luo C-F, Sun H, Zhang B, Zeng B-F. Three-column fixation for complex tibial plateau fractures. J Orthop Trauma. 2010;24:683–92.

    Article  PubMed  Google Scholar 

  22. Wang Y, Luo C, Zhu Y, Zhai Q, Zhan Y, Qiu W, et al. Updated three-column concept in surgical treatment for tibial plateau fractures—a prospective cohort study of 287 patients. Injury. 2016;47:1488–96.

    Article  PubMed  Google Scholar 

  23. Walton NP, Harish S, Roberts C, Blundell C. AO or Schatzker? How reliable is classification of tibial plateau fractures? Arch Orthop Trauma Surg. 2003;123:396–8.

    Article  CAS  PubMed  Google Scholar 

  24. Mthethwa J, Chikate A. A review of the management of tibial plateau fractures. Musculoskelet Surg. 2018;102:119–27.

    Article  CAS  PubMed  Google Scholar 

  25. Statistisches Amt München—ZIMAS 2021.

  26. Herteleer M, Van Brandt C, Vandoren C, Nijs S, Hoekstra H. Tibial plateau fractures in Belgium: epidemiology, financial burden and costs curbing strategies. Eur J Trauma Emerg Surg. 2020. https://doi.org/10.1007/s00068-020-01525-8.

    Article  PubMed  Google Scholar 

  27. Hopewell S. Multifactorial and multiple component interventions for preventing falls in older people living in the community. Cochrane Library. 2018. https://doi.org/10.1002/14651858.CD012221.pub2/full.

    Article  Google Scholar 

  28. Ali M, Eiriksdottir A, Murtadha M, Åkesson A, Atroshi I. Incidence of distal radius fracture in a general population in southern Sweden in 2016 compared with 2001. Osteoporos Int. 2020;31:715–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Wilcke MKT, Hammarberg H, Adolphson PY. Epidemiology and changed surgical treatment methods for fractures of the distal radius: a registry analysis of 42,583 patients in Stockholm County, Sweden, 2004–2010. Acta Orthop. 2013;84:292–6.

    Article  PubMed  PubMed Central  Google Scholar 

  30. McLellan AR, Gallacher SJ, Fraser M, McQuillian C. The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture. Osteoporos Int. 2003;14:1028–34.

    Article  PubMed  Google Scholar 

  31. Nakayama A, Major G, Holliday E, Attia J, Bogduk N. Evidence of effectiveness of a fracture liaison service to reduce the re-fracture rate. Osteoporos Int. 2016;27:873–9.

    Article  CAS  PubMed  Google Scholar 

  32. Hadji P, Klein S, Gothe H, Häussler B, Kless T, Schmidt T, et al. The epidemiology of osteoporosis–bone evaluation study (BEST): an analysis of routine health insurance data. Dtsch Arztebl Int. 2013;110:52–7.

    PubMed  PubMed Central  Google Scholar 

  33. Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury. 2006;37:691–7.

    Article  PubMed  Google Scholar 

  34. Blain H, Masud T, Dargent-Molina P, Martin FC, Rosendahl E, van der Velde N, et al. A comprehensive fracture prevention strategy in older adults: the European Union geriatric medicine society (EUGMS) statement. Aging Clin Exp Res. 2016;28:797–803.

    Article  CAS  PubMed  Google Scholar 

  35. Gosch M, Kammerlander C, Neuerburg C. Osteoporose—epidemiologie und versorgungsqualität. Z Gerontol Geriat. 2019;52:408–13.

    Article  CAS  Google Scholar 

  36. Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006;17:1726–33.

    Article  CAS  PubMed  Google Scholar 

  37. Mustonen AOT, Koskinen SK, Kiuru MJ. Acute knee trauma: analysis of multidetector computed tomography findings and comparison with conventional radiography. Acta Radiol. 2005;46:866–74.

    Article  CAS  PubMed  Google Scholar 

  38. Kfuri M, Schatzker J. Revisiting the schatzker classification of tibial plateau fractures. Injury Elsevier. 2018;49:2252–63.

    Article  Google Scholar 

  39. Yacoubian SV, Nevins RT, Sallis JG, Potter HG, Lorich DG. Impact of MRI on treatment plan and fracture classification of tibial plateau fractures. J Orthop Trauma. 2002;16:632–7.

    Article  PubMed  Google Scholar 

  40. Millar SC, Arnold JB, Thewlis D, Fraysse F, Solomon LB. A systematic literature review of tibial plateau fractures: what classifications are used and how reliable and useful are they? Injury. 2018;49:473–90.

    Article  PubMed  Google Scholar 

  41. Jensen DB, Rude C, Duus B, Bjerg-Nielsen A. Tibial plateau fractures a comparison of conservative and surgical treatment. J Bone Joint Surg Br. 1990;72(4):9–52.

    Google Scholar 

Download references

Author information

Author notes

  1. Markus Bormann and Claas Neidlein ave contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany

    Markus Bormann, Claas Neidlein, Christoph Gassner, Alexander Martin Keppler, Viktoria Bogner-Flatz, Christian Ehrnthaller, Wolf Christian Prall, Wolfgang Böcker & Julian Fürmetz

  2. Devision of Knee, Hip, Shoulder and Ellbow Surgery, Schoen Clinic Munich, Harlachinger Straße 51, 81547, Munich, Germany

    Wolf Christian Prall

  3. Department of Trauma Surgery, Trauma Center Murnau, Professor-Küntscher-Straße 8, 82418, Murnau am Staffelsee, Germany

    Julian Fürmetz

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  1. Markus Bormann
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Correspondence to Julian Fürmetz.

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Conflict of interest

All authors declare that they have no conflict of interest. All authors certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

The study was approved by the local Ethical Committee. (21–0559).

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Bormann, M., Neidlein, C., Gassner, C. et al. Changing patterns in the epidemiology of tibial plateau fractures: a 10-year review at a level-I trauma center. Eur J Trauma Emerg Surg 49, 401–409 (2023). https://doi.org/10.1007/s00068-022-02076-w

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