Operative Treatment of Tibial Plateau Fractures in Patients Older Than 55 Years

Circular external fixation in the management of tibial plateau fractures in patients over the age of 55 years

“…16,17 The Schatzker classification is, however, not necessarily predictive of the clinical outcome in patients over the age of 55 years. 9 Furthermore, there appears to be no correlation between the radiological and clinical outcome of treatment. 9,12 While radiographic progression of osteoarthrosis occurs in up to 60% of patients, less than 10% of patients go on to require total knee replacement.…”

“…9 Furthermore, there appears to be no correlation between the radiological and clinical outcome of treatment. 9,12 While radiographic progression of osteoarthrosis occurs in up to 60% of patients, less than 10% of patients go on to require total knee replacement. 9 Su et al found that the need for arthroplasty becomes evident relatively early and total knee replacements were performed at an average of one year after the injury.…”

“…9,12 While radiographic progression of osteoarthrosis occurs in up to 60% of patients, less than 10% of patients go on to require total knee replacement. 9 Su et al found that the need for arthroplasty becomes evident relatively early and total knee replacements were performed at an average of one year after the injury. 9 Finally, the incidence of associated knee ligament injuries is also lower in the elderly, approximately 3%, compared to 20-25% in younger patients.…”

“…8 Tibial plateau fractures in the elderly poses some additional challenges because of coexisting medical problems, pre-existing degenerative joint disease and osteoporosis. 9 Bone mineral density (BMD) is significantly decreased after the age of 60 years in female patients. 10 Quantitative computed tomography analysis has revealed that the BMD of the tibial plateau is lowest in the central and antero-medial regions and highest in the postero-medial or postero-lateral regions.…”

“…1,2,8 In the elderly hybrid external fixation has been reported to deliver inferior results in comparison to internal fixation. 9 This study aims to compare the complication and union rate of conventional circular external fixation in patients over the age of 55 years with that achieved in younger patients. Ethical approval was obtained from our institution's ethics review board prior to commencement of the study.…”