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Complications and secondary operations after non-operative and operative treatment of tibial plateau fractures: a population-based study of 562 patients with mean follow-up of 7 years

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The incidence of tibial plateau fractures (TPF) is 1% of all fractures and increases with age. Whether non-operatively or operatively treated, complications (infection, malalignment, loss of reduction and delayed union or nonunion) and post-traumatic osteoarthritis are not uncommon, and the risk for complications has generally been assumed to rise with age. This study investigated all post-TPF complications and secondary surgery after non-operative and operative treatment. Secondary aims were to determine the incidence and epidemiology of TPF in the population of the Central Finland region.

Materials and methods

All patients over age 18 years with a TPF, including incidence, etiology, fracture type, and possible complications and reoperations, sustained during the period 1998–2019 were retrospectively identified from hospital records.

Results

The annual mean incidence of TPF was 14.4/100,000, with older women at highest risk. The proportions of non-operative and operatively treated patients who had undergone at least one additional surgical operation were 6% and 26%, respectively. Age and female gender were identified as risk factors for complications and secondary operations. The risk peaked in patients aged 60–65 years, decreasing thereafter. Non-operative treatment showed low risk for both non-union and loss of reduction.

Conclusions

Older women were at the highest risk for TPF and for subsequent complications and secondary operations after TPF. Secondary operations after operatively treated TPF were not uncommon and patients aged 60–65 years were at highest risk. Given the low rates of complications and re-operations, non-operative treatment may be a safe option in cases of all minimally displaced TPF.

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Data availability

The data is available on request.

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Acknowledgements

We thank Jani Saalamo for his help with the hospital database.

Funding

National Science Foundation, Finland.

Author information

Authors and Affiliations

  1. Department of Surgery, Hospital Nova, Wellbeing Services County of Central Finland, Keskussairaalantie 19, 40620, Jyvaskyla, Finland

    Valtteri Tapper, Alar Toom & Juha Paloneva

  2. Department of Surgery, Tampere University Hospital, Tampere, Finland

    Aleksi Reito & Antti Ylitalo

  3. University of Eastern Finland, Kuopio, Finland

    Juha Paloneva

  4. Coxa Hospital for Joint Replacement, Tampere, Finland

    Konsta Pamilo

Authors
  1. Valtteri Tapper
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  2. Aleksi Reito
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  3. Konsta Pamilo
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  6. Juha Paloneva
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Contributions

Study design VT, AR, JP. Data collection VT. Data analysis: VT, AR. Manuscript preparation VT, AR, KP, AT, AY, JP.

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Correspondence to Valtteri Tapper.

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All the authors declare no conflict of interest.

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The Institutional Review Board approved this registry study.

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Appendix

Appendix

Crosstab of trauma energy (H = high, L = low) and fracture type (Schatzker I–VI)

figure a

Analysis of variance (ANOVA) between age and fracture classification

figure b

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Tapper, V., Reito, A., Pamilo, K. et al. Complications and secondary operations after non-operative and operative treatment of tibial plateau fractures: a population-based study of 562 patients with mean follow-up of 7 years. Arch Orthop Trauma Surg 144, 269–280 (2024). https://doi.org/10.1007/s00402-023-05102-7

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