TIBIAL PLATEAU FRACTURES

The classification of tibial plateau fractures is based on morphologic al criteria according to AO/ASIF [18] and Schatzker [21] or on functio nal criteria according to Moore [15]. A total of 81 acute tibial plate au fractures were operated on over a 6-year period. The patient data a nd the operative procedure are given (not including late results). Som e 6% of ligamentous lesions were treated conservatively. Bicondylar os teosynthesis was performed in 11 %, and 14 % of the operations were mi nimally invasive procedures. In 61.7 % the plateau was fixed by a butt ress plate. Autologous cancellous bone from the iliac crest was implan ted into the fracture, especially into depressed wedge fractures (Type AO/ASIF B3 or Moore Type IV). In 39.5 % of the cases a corticocancell ous wedge-shaped bone chip from the iliac crest was used. Compications were rare, and no infection was observed. Most important are the soft tissue balance, the timing of surgery, choice of longitudinal incisio ns directly above the lesion, and a stabilization procedure which main tains blood flow and coverage of the fracture. The operative procedure s are described including tibial plateau fractures in children and the management of complications. In speical situations a conservative tre atment is still useful.