[Complications in complex fractures of the tibial plateau and associated factors].
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.
Cuéllar-Avaroma
Alberto
A
Hospital de Traumatología Dr. Victorio de la Fuente Narváez, Unidad Médica de Alta Especialidad Magdalena de las Salinas, Instituto Mexicano del Seguro Social, D.F., México.
King-Martínez
Ana Cristina
AC
Hernández-Salgado
Armando
A
Torres-González
Rubén
R
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws; D016022:Case-Control Studies; D015897:Comorbidity; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D005594:Fracture Fixation, Intramedullary / Q000706:statistics & numerical data; D017102:Fracture Healing; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices / Q000009:adverse effects / Q000706:statistics & numerical data; D016268:Internal Fixators; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology; D007511:Ischemia / Q000453:epidemiology / Q000209:etiology; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D010543:Peroneal Nerve / Q000293:injuries; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011859:Radiography; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology; D013924:Thrombophlebitis / Q000453:epidemiology; D013978:Tibial Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*