Worku Adugnaw Bogale, Kebede Molla Asnake, Abate Alemayehu Dagne, Admassie Solyana Haileselassie, Girma Meskerem, Zewde Bekalu Wubshet, Dessie Mekuanint, Negatie Hashime Meketa, Techane Adefris Getachew, Wudineh Abebe Agegn
Department of Orthopedic Surgery, School of Medicine, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia.
Department of Medicine, School of Medicine, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia.
PLoS One. 2025 May 23;20(5):e0323956. doi: 10.1371/journal.pone.0323956. eCollection 2025.
Tibial plateau fractures, accounting for approximately 1% of adult fractures, are often associated with significant long-term complications such as pain, stiffness, and posttraumatic arthrosis. The optimal treatment approach remains controversial, particularly in resource-limited settings. This study investigated the factors influencing the clinical outcomes of patients with tibial plateau fractures in Ethiopia.
Tibial plateau fractures, though common in trauma cases, have been poorly studied in sub-Saharan Africa, particularly in Ethiopia. The primary purpose of this study was to examine the factors influencing the clinical outcomes of patients with tibial plateau fractures and to assess the efficacy of conservative treatment versus surgical intervention. This research aims to provide insights into managing tibial plateau fractures in resource-limited settings, with the hope of contributing to improved clinical practices.
A total of 191 patients with tibial plateau fractures were recruited from Tibebe Ghion Referral Hospital and Felegehiwot Specialized Hospital between February 1, 2018, and February 2022. Demographic, clinical, and radiological data were analyzed, and treatment outcomes were assessed via Rasmussen's knee functional outcome score. A correlation analysis was performed to identify factors impacting functional outcomes. Logistic regression was used to identify factors influencing clinical outcomes.
The study population was predominantly male (73.8%), with a mean age of 45 years. Road traffic accidents (41.9%) were the most common cause of injury. Schatzker type I fractures (27.2%) were the most common, and compound fractures accounted for 21% of the fractures. The average time to definitive management was 1.59 weeks, with 35% of patients undergoing open reduction and internal fixation (ORIF). The duration of immobilization and weight-bearing significantly influenced functional outcomes. Patients who were immobilized for less than 4 weeks had better outcomes, with functional scores 54 times better than those of patients who were immobilized for more than 8 weeks (p < 0.01). Early initiation of partial weight-bearing also improved outcomes. A strong negative relationship was found between the duration of immobilization and functional outcomes (r = -0.705, p < 0.01).
This study highlights the importance of early mobilization and optimal management of tibial plateau fractures for improving functional outcomes. Timely treatment, especially regarding immobilization and weight-bearing, is crucial for achieving better results. These findings emphasize the need for more standardized treatment protocols and further research on tibial plateau fractures in sub-Saharan Africa to increase patient care in resource-limited settings.
胫骨平台骨折约占成人骨折的1%，常伴有疼痛、僵硬和创伤后关节炎等严重的长期并发症。最佳治疗方法仍存在争议，尤其是在资源有限的环境中。本研究调查了影响埃塞俄比亚胫骨平台骨折患者临床结局的因素。
胫骨平台骨折在创伤病例中很常见，但在撒哈拉以南非洲，特别是在埃塞俄比亚，对此研究较少。本研究的主要目的是检查影响胫骨平台骨折患者临床结局的因素，并评估保守治疗与手术干预的疗效。本研究旨在为资源有限环境下的胫骨平台骨折管理提供见解，希望有助于改进临床实践。
2018年2月1日至2022年2月期间，从蒂贝贝·吉翁转诊医院和费莱盖希沃特专科医院招募了191例胫骨平台骨折患者。分析了人口统计学、临床和放射学数据，并通过拉斯穆森膝关节功能结局评分评估治疗效果。进行相关性分析以确定影响功能结局的因素。使用逻辑回归确定影响临床结局的因素。
研究人群以男性为主（73.8%），平均年龄45岁。道路交通事故（41.9%）是最常见的受伤原因。沙茨克I型骨折（27.2%）最常见，开放性骨折占骨折总数的21%。确定性治疗的平均时间为1.59周，35%的患者接受切开复位内固定术（ORIF）。固定和负重的持续时间对功能结局有显著影响。固定时间少于4周的患者结局更好，功能评分比固定时间超过8周的患者高54倍（p < 0.01）。早期开始部分负重也改善了结局。固定持续时间与功能结局之间存在强烈的负相关（r = -0.705，p < 0.01）。
本研究强调了早期活动和胫骨平台骨折的优化管理对改善功能结局的重要性。及时治疗，特别是在固定和负重方面，对于取得更好的结果至关重要。这些发现强调需要更标准化的治疗方案，并对撒哈拉以南非洲的胫骨平台骨折进行进一步研究，以提高资源有限环境下的患者护理水平。
