Abstract
Proximal tibial fractures consist of 8% of all fractures in the elderly. The mechanism of injury is commonly lower energy in simple falls while ambulatory patients with higher energy mechanisms in motor vehicle and cycling accidents are also common. High energy related soft tissue conditions are rarer yet challenging to handle. Because of osteoporosis and bone metabolic disorders, articular depression and sizable cancellous defects are common. Medical comorbidities and coexisting osteoarthritis impose unique management challenges. The recovery of elderly patients is critically affected by comorbidities. Mobilization regimens favour early weight bearing. Prolonged immobilization in the elderly is associated with deconditioning and medical complications such as pressure sores, chest and urinary tract infections, loss of muscle mass, and contractures and should be avoided.
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References
Schatzker J. Compression in the surgical treatment of fractures of the tibia. Clin Orthop Relat Res. 1974;105:220–39.
Chang S-M, et al. A surgical protocol for bicondylar four-quadrant tibial plateau fractures. Int Orthop. 2014;38(12):2559–64.
MartÃnez-Rondanelli A, et al. Reliability of a four-column classification for tibial plateau fractures. Int Orthop. 2017;41(9):1881–6.
Kfuri M, Schatzker J. Revisiting the Schatzker classification of tibial plateau fractures. Injury. 2018;49(12):2252–63.
Frosch KH, et al. A new posterolateral approach without fibula osteotomy for the treatment of tibial plateau fractures. J Orthop Trauma. 2010;24(8):515–20.
Yu B, et al. Fibular head osteotomy: a new approach for the treatment of lateral or posterolateral tibial plateau fractures. Knee. 2010;17(5):313–8.
Cho JW, et al. Approaches and fixation of the posterolateral fracture fragment in tibial plateau fractures: a review with an emphasis on rim plating via modified anterolateral approach. Int Orthop. 2017;41(9):1887–97.
Weil YA, et al. Posteromedial supine approach for reduction and fixation of medial and bicondylar tibial plateau fractures. J Orthop Trauma. 2008;22(5):357–62.
Hartigan DE, et al. Arthroscopic-assisted reduction and percutaneous fixation of tibial plateau fractures. Arthrosc Tech. 2015;4(1):e51–5.
Wong MT, et al. Understanding the role of total knee arthroplasty for primary treatment of tibial plateau fracture: a systematic review of the literature. J Orthop Traumatol. 2020;21(1):7.
Sabatini L, et al. Primary total knee arthroplasty in tibial plateau fractures: literature review and our institutional experience. Injury. 2023;54 Suppl 1:S15–23.
Parratte S, Ollivier M, Argenson JN. Primary total knee arthroplasty for acute fracture around the knee. Orthop Traumatol Surg Res. 2018;104(1s):S71–s80.
Aurich M, Koenig V, Hofmann G. Comminuted intraarticular fractures of the tibial plateau lead to posttraumatic osteoarthritis of the knee: current treatment review. Asian J Surg. 2018;41(2):99–105.
Gausewitz S, Hohl M. The significance of early motion in the treatment of tibial plateau fractures. Clin Orthop Relat Res. 1986;202:135–8.
Polat B, et al. Factors influencing the functional outcomes of tibia plateau fractures after surgical fixation. Niger J Clin Pract. 2019;22(12):1715–21.
Williamson M, et al. Immediate weight bearing after plate fixation of fractures of the tibial plateau. Injury. 2018;49(10):1886–90.
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© 2024 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Fang, C. (2024). Proximal Tibial Fractures. In: Leung, F., Lau, T.W. (eds) Surgery for Osteoporotic Fractures. Springer, Singapore. https://doi.org/10.1007/978-981-99-9696-4_11
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DOI: https://doi.org/10.1007/978-981-99-9696-4_11
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