![]() ![]() The database search yielded 640 abstracts after removal of duplications. Conference abstracts, book chapters, and reviews were also excluded from our search. Studies of osteosynthesis, external fixator, or any other treatment were excluded, as were studies on stress fractures, intra-operative fractures, pathologic fractures, and tibial fractures treated with secondary TKR. ![]() Here we present a systematic review of all the relevant literature and summarize the current evidence-based knowledge on the treatment of tibial plateau fractures with primary TKR in older people. It could be a feasible first-line treatment, especially in fragile older patients. In view of the above-mentioned complications, primary total knee replacement (TKR) is an under-reported treatment option. However, many other studies have reported ORIF to have good outcomes in older people. Some studies have found a high risk of complications, such as infections, loss of reduction, malalignment, delayed union or nonunion, and risk for the development of post-traumatic osteoarthritis (OA). Ĭonflicting results have been reported for open reduction and internal fixation (ORIF) of tibial plateau fractures in older people. The incidence of tibial plateau fractures will increase in the future. Of all intra-articular proximal tibia fractures, 24% occur in older persons and account for 8% of all fractures in patients over age 65 years. The incidence of tibial plateau fractures rises with age, and the majority of patients are women. Tibial plateau fractures, in turn, have been associated with higher mortality. Proximal tibia fractures are relatively common in the older population, but demanding to treat. It has been assumed that peri-articular fractures around the knee can be similarly treated, especially in patients with osteoporosis and with fractures that are difficult to reconstruct or may lead to rapid progression of post-traumatic osteoarthritis. More recently, arthroplasty has also become a significant primary treatment option for complex elbow and shoulder fractures. ![]() Controlled trials are mandatory to determine the relative superiority of these two options as primary treatment of tibial plateau fractures in older patients.įor many years, arthroplasty has been the gold standard treatment for femoral neck fractures in older patients. Conclusionīased on low-quality evidence, TKR appears to be a useful treatment option for tibial plateau fractures in older patients. Four-year follow-up complication (6.1%) and revision (3.6%) rates after primary TKR appeared to be lower than after secondary TKR (complication rate 20–48%, revision rate 8–20%) but higher than after elective primary TKR. The results, using different clinical scoring systems, were good or fair. No controlled trials were available, and the overall quality of the literature was low. Of the 640 reviewed articles, 16 studies with a total of 197 patients met the inclusion criteria. We included all studies without restrictions regarding total knee replacement (TKR) as primary treatment for acute traumatic tibial plateau fracture. Materials and methodsĪ systematic literature search of studies on total knee replacement (TKR) as primary treatment for acute traumatic tibial plateau fracture was conducted using OVID Medline, Scopus, and Cochrane databases from 1946 to 18 November 2019. The aim of this study was to evaluate all the relevant literature and summarize the current evidence-based knowledge on the treatment of tibial plateau fractures with primary TKR in older patients. To avoid these problems, primary total knee replacement (TKR) has become an increasingly common treatment option. In older patients, osteosynthesis is associated with some complications, risk of post-traumatic osteoarthritis and long partial, or non-weight bearing during the recovery phase. Tibial plateau fractures are typically treated with osteosynthesis. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |