Surgical treatment of tibial plateau fracture in elderly patients

This retrospective study involves 22 patients with displaced tibial plateau fractures who were treated surgically from July 1993 to April 1996. All th e patients were over 60 years old (mean 66.3 years old, range 61-80 years). All of the patients were treated by open reduction and internal fixation w ith AO/ASIF buttress plates (Synthes, Bochum, Switzerland). Additional smal l fragment plate or inter-fragmental screws were used in some of them as in dicated. Two patients died during follow-up of causes unrelated to the frac tures. The average followup time was 49.8 months (range 36-68 months). The other 20 patients were interviewed at the outpatient clinic, and radiograph s of bilateral standing knees were taken. By comparison with the uninjured side on radiographs, condylar joint space depression was noted in 6 patient s. However, joint depression greater than 4 mm was not found. Malalignment with varus or valgus greater than 5 deg was not demonstrated in any case. T heir range of motion was restored in all patients, with more than 120 deg o f flexion and without extension lag except for the one who suffered a super ficial wound infection. No complication required further surgical managemen t. During the period of follow-up, no accelerated degenerative change in th e operated knee joint resulted in total knee arthroplasty, Two patients nee ded occasional medical treatment for residual knee joint pain. Only two pat ients needed canes for assistance during walking due to old age and minor s troke. The results justify surgical treatment for displaced tibial plateau fractures in elderly patients.