Sauhta Ravi, Makkar Dheeraj
Artemis Hospital Gurgaon, Gurgaon, Haryana India.
University of Iowa Hospital and Clinics, Iowa City, Iowa USA.
Indian J Orthop. 2025 Feb 16;59(3):326-345. doi: 10.1007/s43465-025-01337-1. eCollection 2025 Mar.
Tibial plateau fractures are frequently observed in elderly patients, often resulting from low-energy trauma. The treatment of tibial plateau fractures in this population is further complicated by factors such as osteoporosis, osteoarthritis, and other medical comorbidities.
This article provides a comprehensive review of the different treatment strategies for proximal tibial fractures in the elderly. A variety of internal and external fixation techniques, medical management as well as acute arthroplasty, are discussed as potential approaches for achieving optimal reconstruction and functional recovery.
Existing literature emphasizes that osteoporotic bones, characterized by reduced bone density and compromised structural integrity, pose significant challenges to fracture fixation. These factors often diminish the efficacy of fixation devices in proximal tibial fractures, leading to an increased likelihood of fixation failure.
While the high failure rates associated with osteoporotic bone fixation are wellrecognized, there is a notable lack of comprehensive studies that integrate biomechanical, biological, and technological advancements to improve fixation outcomes, in proximal tibial fractures. This article aims to address this gap by reviewing current diagnostic approaches and exploring innovative strategies involving advanced materials and regenerative technologies designed to enhance fixation success.
The management of proximal tibial fractures in the elderly requires a nuanced approach that integrates surgical intervention with medical management. A tailored treatment plan, based on specific fracture characteristics and overall health, is critical to optimizing postoperative functional outcomes. This article emphasizes the importance of a comprehensive, individualized treatment strategy to improve recovery and quality of life for elderly patients suffering from tibial plateau fractures.
胫骨平台骨折在老年患者中较为常见,通常由低能量创伤引起。骨质疏松、骨关节炎和其他合并症等因素使该人群胫骨平台骨折的治疗更加复杂。
本文全面综述了老年患者胫骨近端骨折的不同治疗策略。讨论了各种内固定和外固定技术、药物治疗以及急性关节置换术,作为实现最佳重建和功能恢复的潜在方法。
现有文献强调,骨质疏松性骨以骨密度降低和结构完整性受损为特征,给骨折固定带来重大挑战。这些因素常常降低胫骨近端骨折固定装置的疗效,导致固定失败的可能性增加。
虽然与骨质疏松性骨固定相关的高失败率已得到充分认识,但显著缺乏综合研究,这些研究整合生物力学、生物学和技术进步以改善胫骨近端骨折的固定效果。本文旨在通过综述当前诊断方法并探索涉及先进材料和再生技术的创新策略来填补这一空白,这些策略旨在提高固定成功率。
老年患者胫骨近端骨折的治疗需要一种细致入微的方法,将手术干预与药物治疗相结合。基于特定骨折特征和整体健康状况制定的个性化治疗方案对于优化术后功能结果至关重要。本文强调全面、个性化治疗策略对于改善胫骨平台骨折老年患者的恢复情况和生活质量的重要性。