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Post-operative complications of tibial plateau fractures treated with screws or hybrid external fixation

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MUSCULOSKELETAL SURGERY Aims and scope Submit manuscript

Abstract

Purpose

To assess the complications and second surgeries rates at 1 year follow-up in a group of patients underwent minimally invasive fixation with screws or hybrid external fixation (HEF) for tibial plateau fractures (TPF). The hypothesis was that low Schatzker (I–IV) TPF would have shown a lower complication rate with respect to high Schatzker (V–VI) TPF.

Methods

148 patients who underwent minimally invasive surgery with screws or HEF for TPF were included and pooled in two groups: mono-condylar (Schatzker I–IV) and bi-condylar (Schatzker V–VI). The rate of second surgeries and complications, such as stiffness, infection, wound dehiscence and malunion occurred within 1 year, were reported.

Results

Statistically significant difference between mono-condylar and bi-condylar groups was found in terms of stiffness (18% vs. 37%, p = 0.01), malunion (4% vs 21%, p = 0.004) and second surgeries (32% vs. 48%, p = 0.049). Associated procedures performed during TPF fixation increased risk of second surgeries (OR 2.1, p < 0.001). No differences in terms of second surgeries and complications were found in bi-condylar group treated with screws and HEF.

Conclusion

Bi-condylar TPF treated with minimally invasive surgery developed a significantly higher rates of stiffness, malunion and second surgeries within 1 year compared to mono-condylar fractures. Moreover, when an associated procedure was performed, the risk of a reoperation was nearly doubled.

Trial registration number PG 0012506 CE AVEC 620/2018/Oss/IOR.

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Availability of data and materials

The dataset analysed in this study is available from the corresponding author on reasonable request.

Code availability

All the statistical analyses were performed in SPSS (v26, IBM, Armonk, NY, US).

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Funding

No financial support was received for the present study.

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Authors and Affiliations

  1. II Orthopaedic and Traumatologic Clinic, IRCCS – Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy

    F. Stefanelli, I. Cucurnia, A. Grassi, N. Pizza, M. Casali, F. Raggi, M. Romagnoli & S. Zaffagnini

  2. Department for Life Quality Studies, University of Bologna, Bologna, Italy

    S. Di Paolo

  3. Dipartimento di Scienze Biomediche e Neuromotorie DIBINEM, Università di Bologna, Bologna, Italy

    S. Zaffagnini

Authors
  1. F. Stefanelli
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  2. I. Cucurnia
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  3. A. Grassi
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  4. N. Pizza
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  5. S. Di Paolo
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  7. F. Raggi
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Contributions

RF, DPS, CM, NP performed the literature research, drafted the manuscript, collected the data, derived results and prepared the tables. SF, CI, GA and RM were involved in the conception and design of the study, oversaw and provided quality assurance on study output and assisted in revising the manuscript. All the patients included in this study were operated by the groups directed by SZ. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to F. Stefanelli.

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Conflict of interest

All authors declare that they have no conflict of interest.

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Each patient gave his/her informed consent to participate in this retrospective study.

Consent for publication

Consent to publish individual data was obtained by patients.

Ethics approval

The research study was approved by the local Institutional Review Board (PG 0012506 CE AVEC 620/2018/Oss/IOR).

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Stefanelli, F., Cucurnia, I., Grassi, A. et al. Post-operative complications of tibial plateau fractures treated with screws or hybrid external fixation. Musculoskelet Surg 106, 469–474 (2022). https://doi.org/10.1007/s12306-021-00726-7

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  • DOI: https://doi.org/10.1007/s12306-021-00726-7

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