Cast brace treatment of proximal tibia fractures. A ten-year follow-up study.

The long-term outcome of tibial plateau fractures treated by cast bracing was observed in 29 patients sustaining 30 tibial plateau fractures more than ten years after injury. Clinical and roentgenographic evaluation was performed and showed 61% good results overall. Range of motion averaged 117 degrees. Iowa knee score averaged 71 of 100 possible points. Thirty-two percent of the patients developed moderate or severe roentgenographic posttraumatic degenerative arthritis. Minimally displaced fractures were observed to do very well clinically without roentgenographic evidence of degenerative joint disease after a ten-year follow-up period. Seventy percent of displaced bicondylar fractures developed degenerative joint disease in clinical and roentgenographic evaluation. Cast bracing of minimally displaced fractures gave satisfactory results, whereas cast bracing of more complex fractures produced variable functional results.