title: Minimally invasive plate osteosynthesis for tibial plateau fractures.
abstract: OBJECTIVE
  To evaluate radiological and clinical outcome of minimally invasive plate osteosynthesis (MIPO) for tibial plateau fractures.
  
  
  METHODS
  35 men and 6 women aged 19 to 75 (mean, 40; standard deviation [SD], 14) years underwent MIPO for displaced tibial plateau fractures. According to the Schatzker system, the tibial plateau fractures were classified as types I (n=3), II (n=9), III (n=11), IV (n=6), V (n=7), and VI (n=5). Six patients had open fractures; 2 of them underwent debridement before MIPO. 10 patients needed additional bone grafting. Radiological (at immediate postoperation) and clinical (at the 12-month follow-up) assessments based on the Rasmussen anatomic and functional scoring system were recorded using a proforma. Patients with acceptable and unacceptable outcomes were compared in terms of age.
  
  
  RESULTS
  The mean Rasmussen anatomic score was 15.1 (SD, 2.2; range, 10-18); the mean Rasmussen functional score was 25.3 (SD, 3.2; range, 14-29); and the mean range of knee motion was 118 (SD, 10; range, 90-140) degrees. Anatomic outcome was excellent in 10, good in 28, and unacceptable in 3 patients (one each had Schatzker type-I, -II, and -III fractures). 27 (71%) of the 38 patients with acceptable anatomic outcome were aged 45 years or younger, whereas 2 (67%) of the 3 patients with unacceptable anatomic outcome were aged 60 years or older (p=0.001). Functional outcome was excellent in 18, good in 19, and unacceptable in 4 patients (2 had Schatzker type-III and another 2 had Schatzker type-I or -II fractures). 37 of the patients had a range of knee motion of 120 degrees or more; 27 (73%) of them were aged 45 years or younger, whereas 3 (75%) of the 4 patients with unacceptable functional outcome were aged 60 years or older (p=0.001).
  
  
  CONCLUSIONS
  MIPO for tibial plateau fractures achieved good outcome with minimal soft-tissue complications. Older age was the predictor of unacceptable outcome.
authors.affiliation: Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan. hasnain95@yahoo.com
authors.forename: Hasnain
authors.initials: H
authors.lastname: Raza
authors.forename: Pervaiz
authors.initials: P
authors.lastname: Hashmi
authors.forename: Kashif
authors.initials: K
authors.lastname: Abbas
authors.forename: Kamran
authors.initials: K
authors.lastname: Hafeez
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D013978:Tibial Fractures / Q000601:surgery; D055815:Young Adult