Tibial Plateau Fractures: Epidemiological, Clinical, Therapeutic, and Evolutive Aspects in the Orthopedic-Traumatology Department of the Ignace Deen National Hospital

Author(s): Mamady DOUKOURE, Watta CISSE, Abdoulaye CAMARA, Badara DIOP, Tafsir CAMARA, Ibrahima Sory CAMARA, Madiou DIALLO, Mamady Sékou CONDÉ, Tanou BAH, Hawa Lamarana DIALLO, Mohamed Lamine BAH, Léopold LAMAH

Introduction: Tibial plateau fractures are breaks in the bone continuity of the epiphyseal-metaphyseal cancellous bone at the upper end of the tibia, with at least one line reaching the articular cartilage. The aim of this study was to determine the epidemiological, clinical, therapeutic and evolutive aspects of tibial plateau fractures.

Methodology: This was a 12-month prospective descriptive study conducted from March 16, 2014, to February 14, 2015, at the Ignace Deen National Hospital in Conakry. All patients admitted, treated, and followed up for tibial plateau fractures in the department during our study period were included in this study.

Results: We recorded 18 patients, representing 0.36% of consultations and 0.42% of hospitalizations. Males predominated in 83% of cases, with a sex ratio of 5. The average age was 35.5 years, with extremes of 11 and 60 years. The 21-30 age group was the most affected, accounting for 38.89%. Road traffic accidents were the most common etiological circumstances, accounting for 66%. Direct impact was the most common mechanism in 89% of cases, and closed fractures were predominant in 71.43% of cases. Unitubercular fractures were the most common in 72.22% of cases. Associated injuries were skin injuries in 16.67% of cases, ligament injuries in 16.67%, and meniscal injuries in 33.33%. Treatment was surgical in 72.22% of cases and orthopedic in 27.78%. The outcome was good in 66.67% of cases, compared with 33.33% of cases involving infection and exposure of the osteosynthesis material.

Conclusion: Tibial plateau fractures are serious joint fractures that affect the functional prognosis of the knee. Whenever possible, treatment should be surgical to allow restoration of the anatomy of the knee. The fundamental and essential step in treatment is early, careful, and diligent rehabilitation of the knee.