Published: 2020-02-25

Assessment of the complications after percutaneous fixation with cannulated cancecellous screws among the cases of tibial plateau fractures in a tertiary healthcare institute: a cross sectional study

Joti P. Bagul, Pankaj P. Dole


Background: Fractures in the tibial plateau were first defined as car bumper fractures. Tibial plateau fractures are a diverse group of fractures that reflect a wide range of intensity, ranging from simple accidents to intricate fracture trends that test even the most qualified surgeons. The present study was conducted to study the result of minimally invasive technique for tibial plateau fractures by percutaneous fixation with cannulated cancellous screws and to study complications associated with it in a tertiary care center.

Methods: It was a cross sectional study conducted among 13 patients with tibial plateau fractures during January 2016 to December 2016 admitted under department of orthopedics in a tertiary healthcare institute in northern Maharashtra. The criteria for selection of a case were a fracture of tibial plateau (Shatzker’s type I to type IV) with displacement or depression more than 8mm.

Results: One patient (7%) had compartment syndrome at the time of presentation. No patient in our series had early postoperative complication. One patient developed knee joint pain 16 months after operation due to early osteo-artgritic changes.

Conclusions: There was no early complication related to surgery like superficial or deep infection, damage to neurovascular structures, etc. Ten patients (76%) achieved full range of knee motion within 3 months after operation. All the fractures were united within 14 weeks duration.


Tibial plateau fractures, Shatzker’s classification, Management, Complications

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Cotton FJ, Berg R. Fender fractures of the tibia at the knee. N Engl J Med. 1929;201:989-95.

Marsh JL. Tibial plateau fractures. In: Bucholz RW, Heckman JD, Court-Brown CM, Tornetta P, McQueen MM, Ricci WM, editors. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2010: 1780-1831.

Jacofsky DJ, Haidukerwych GJ. Insall & Scott Surgery of the knee. Philadelphia: Churchill Livingstone; 2006. Tibia plateau fractures. In: Scott WN; 2006: 1133-1146.

Wang SQ, Gao YS, Wang JQ, Zhang CQ, Mei J, Rao ZT. Surgical approach for high-energy posterior tibial plateau fractures. Indian J Orthop. 2011;45(2):125-31.

Markhardt BK, Gross JM, Monu J. Schatzker Classification of Tibial Plateau Fractures: Use of CT and MR Imaging Improves Assessment. Radio Graphics. 2009;29:585-97.

Zeltser DW, Leopold SS. Classifications in brief: Schatzker classification of tibial plateau fractures. Clin Orthop Relat Res. 2013;471(2):371-4.

Dei Giudici L, Di Muzio F, Bottegoni C, Chillemi C, Gigante A. The role of arthroscopy in articular fracture management: the lower limb. Eur J Orthop Surg Traumatol. 2015;25(5):807-13.

Mittal R, Banerjee S. Proximal femoral fractures: Principles of management and review of literature. J Clin Orthop Trauma. 2012;3(1):15-23.

Apley GA. Fracture of the tibial plateau, Orthop Clin North Am. 1979;10:61-74.

Drennan DB, Locher FG, Maylahn DJ. Fractures of the tibial plateau: Treatment by closed reduction cast. J Bone Joint Surg. 1979;61:989-95.

Schatzker J, McBroom R, Bruce D. The tibial plateau fracture, the Toronto experience. Clin Orthop Relat Res. 1979;(138):94-104.

Hohl M. Tibial condylar fractures. JBJS. 1967;49(7):1455-67.

Porter BB. Crush fracture of lateral tibial condlye. J. Bone Joint Surg. 1970;52:676-87.

Duwelius PJ, Connelly JF. Closed reduction of tibial plateau fracture: A comparison of functional and roentgenographic end results. Clin Ortop. 1968;230:116-26.

Duparc, Ficat. Fracture of the tibial plateau in Insall et al Surgery of the knee 2nd ed. New York, Churchill Livingstone, 1995;2:1074.

Edwards ER, Chin TYP, Bardana D, Bailey M, Williamson OD, Miller R, et al. Func-tional outcome of tibial plateau fractures treated with the fine-wire fixator. Injury. 2005;36(12):1467-75.

Keogh P, Kelly C, Cashman WF, McGuinness AJ, O'Rourke SK. Percutaneous screw fixation of tibial plateau fractures, Injury. 1992;23(6):387-9.

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(1):49-52.

Babis GC, Evangelopoulos DS, Kontovazenitis P, Nikolopoulos K, Soucacos PN. High energy tibial plateau fractures treated with hybrid external fixation. J Orthop Surg Res. 2011;6:35.