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2006, Number 5

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Cir Cir 2006; 74 (5)

Complications in complex fractures of the tibial plateau and associated factors

Cuéllar-Avaroma A, King-Martínez AC, Hernández-Salgado A, Torres-González R

Language: Spanish
References: 18
Page: 351-357
PDF size: 90.44 Kb.


ABSTRACT

Background: We undertook this study to identify factors associated with surgical complications of complex fractures of the tibial plateau.
Methods: We designed a case-control study with 56 patients with a diagnosis of complex fracture in the tibial plateau (IV-VI Schatzker) and with 12.9 ± 3.2 (8-18) months of follow-up. Risk factor exposure was defined as having one or more of the following characteristics: age › 60 years; co-morbidity (diabetes mellitus, systemic arterial hypertension); time of “Kidde” (› 60, › 90, › 120 min) and fracture type IV, V or VI. A case was considered with one or more complications. Results: Mean age was 50.1 ± 15.7 (17-87) years old; 35 patients (62.5%) were males. Homogeneity between groups was shown for age, sex, side effects, type of fracture and time of follow-up; 41.1% of patients had pathological history. All surgeries used pneumatic compression (Kidde) for 91 ± 27.2 (40-175) min. The implants used were plate plus cancellous screws (53.6%), external fixators plus cancellous screws (35.7%), double plate and intramedullary nail. Complications appeared in 37.5% of all patients. Complications reported were superficial infection (16.1%), residual angular deformities (10.7%, varum [7.1%]), peroneal nerve injury (5.4%), non-union (3.5%) and deep venous thrombosis (1.8%); 22.2% of all patients presented more than one complication.
Conclusions: Statistically significant risk factors were age › 60 years and pneumatic compression › 120 min. Patients with one of these characteristics had a three-times risk of complications. No association was demonstrated between type of fracture, surgical treatment, time between injury and the surgery, with development of complications.


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