Department of Surgery, Hospital Nova, Wellbeing Services County of Central Finland, Keskussairaalantie 19, 40620, Jyvaskyla, Finland.
Department of Surgery, Tampere University Hospital, Tampere, Finland.
Arch Orthop Trauma Surg. 2024 Jan;144(1):269-280. doi: 10.1007/s00402-023-05102-7. Epub 2023 Nov 3.
The incidence of tibial plateau fractures (TPF) is 1% of all fractures and increases with age. Whether non-operatively or operatively treated, complications (infection, malalignment, loss of reduction and delayed union or nonunion) and post-traumatic osteoarthritis are not uncommon, and the risk for complications has generally been assumed to rise with age. This study investigated all post-TPF complications and secondary surgery after non-operative and operative treatment. Secondary aims were to determine the incidence and epidemiology of TPF in the population of the Central Finland region.
All patients over age 18 years with a TPF, including incidence, etiology, fracture type, and possible complications and reoperations, sustained during the period 1998-2019 were retrospectively identified from hospital records.
The annual mean incidence of TPF was 14.4/100,000, with older women at highest risk. The proportions of non-operative and operatively treated patients who had undergone at least one additional surgical operation were 6% and 26%, respectively. Age and female gender were identified as risk factors for complications and secondary operations. The risk peaked in patients aged 60-65 years, decreasing thereafter. Non-operative treatment showed low risk for both non-union and loss of reduction.
Older women were at the highest risk for TPF and for subsequent complications and secondary operations after TPF. Secondary operations after operatively treated TPF were not uncommon and patients aged 60-65 years were at highest risk. Given the low rates of complications and re-operations, non-operative treatment may be a safe option in cases of all minimally displaced TPF.
胫骨平台骨折（TPF）的发病率占所有骨折的 1%，并且随着年龄的增长而增加。无论采用非手术治疗还是手术治疗，并发症（感染、对线不良、复位丢失和延迟愈合或不愈合）和创伤后骨关节炎并不少见，并且并发症的风险通常被认为随着年龄的增长而增加。本研究调查了非手术和手术治疗后所有的 TPF 并发症和二次手术。次要目的是确定中芬兰地区人群中 TPF 的发病率和流行病学。
从医院记录中回顾性地确定了 1998 年至 2019 年期间所有年龄在 18 岁以上的 TPF 患者，包括发病率、病因、骨折类型以及可能的并发症和再次手术。
TPF 的年平均发病率为 14.4/100,000，年龄较大的女性风险最高。接受过至少一次额外手术的非手术和手术治疗患者的比例分别为 6%和 26%。年龄和女性性别被确定为并发症和二次手术的危险因素。风险在 60-65 岁的患者中达到峰值，此后逐渐降低。非手术治疗对不愈合和复位丢失的风险较低。
老年女性是 TPF 以及 TPF 后并发症和二次手术的最高风险人群。手术治疗的 TPF 后二次手术并不少见，60-65 岁的患者风险最高。鉴于并发症和再次手术的低发生率，非手术治疗可能是所有轻度移位 TPF 的安全选择。
