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Tibial Plateau Fractures in the Elderly

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Fractures in the Elderly

Part of the book series: Aging Medicine ((AGME))

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Abstract

In light of an ever-aging population, the incidence of osteoporotic fractures continues to rise. The challenges of reduction and fixation in osteopenic bone are well known to orthopedic surgeons. In this context, treatment of elderly tibial plateau fractures must be individualized to the patient and their injury. Low-energy fractures in low-demand patient may best be treated non-operatively with early mobilization. Higher-energy patterns or higher-demand patients should lead to stronger consideration of surgical treatment. Surgical treatment options include internal or external fixation or a combination of the two. While acute arthroplasty has been used for many other osteopenic fractures, especially those of the proximal femur, the benefits and indications of acute arthroplasty for tibial plateau fractures are unknown. Soft tissue compromise, prosthetic infection, and integrity of the extensor mechanism around arthroplasty components are concerns. The exact indications and benefits of each treatment remain unknown. We review these treatments and the data published that supports them to help the surgeon individualize treatment choice for the elderly patient.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Texas Medical School at Houston, Houston, TX, USA

    Krishna C. Vemulapalli & Joshua L. Gary

  2. Department of Orthopaedic Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA

    Joshua C. Rozell

  3. Department of Orthopaedics, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Derek J. Donegan

Authors
  1. Krishna C. Vemulapalli
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  2. Joshua C. Rozell
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  3. Joshua L. Gary
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  4. Derek J. Donegan
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Corresponding author

Correspondence to Joshua L. Gary .

Editor information

Editors and Affiliations

  1. Chair, Geriatric Medicine and Gerontology, Robert and Arlene Kogod Professor of Geriatric Medicine, Department of Medicine, Mayo Clinic School of Medicine, Rochester, Minnesota, USA

    Robert J. Pignolo

  2. Co-Director, Orthopaedic Trauma & Fracture Reconstruction, Advisory Dean, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA

    Jaimo Ahn

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Vemulapalli, K.C., Rozell, J.C., Gary, J.L., Donegan, D.J. (2018). Tibial Plateau Fractures in the Elderly. In: Pignolo, R., Ahn, J. (eds) Fractures in the Elderly. Aging Medicine. Humana Press, Cham. https://doi.org/10.1007/978-3-319-72228-3_14

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  • DOI: https://doi.org/10.1007/978-3-319-72228-3_14

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  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-72226-9

  • Online ISBN: 978-3-319-72228-3

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