title: Complications of high-energy bicondylar tibial plateau fractures treated with dual plating through 2 incisions.
abstract: OBJECTIVE
  To characterize the rate of complications after operative fixation of bicondylar (OTA/AO 41-C) tibial plateau fractures and to evaluate the contribution of common risk factors.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Level 1 regional trauma center.
  
  
  METHODS
  One hundred thirty-eight patients older than 18 years with 140 bicondylar tibial plateau fractures were participated in this study.
  
  
  METHODS
  Open reduction and internal fixation using medial and lateral plate construct through 2 incisions.
  
  
  METHODS
  Development of a deep infection or a nonunion.
  
  
  RESULTS
  The overall major complication rate was 27.9%: 23.6% deep infection and 10.0% nonunion. Open fractures were associated with a higher rate of infection: 43.8% versus 21.0% for closed injuries (odds ratio = 2.96, P = 0.05). Fasciotomy closure before definitive fixation was associated with significantly fewer deep infections compared with internal fixation with open fasciotomy wounds: 11.8% versus 50.0% (odds ratio = 7.5, P = 0.05). The presence of compartment syndrome, tobacco use, diabetes, and timing of surgery had no statistically significant association on the rate of infection or nonunion.
  
  
  CONCLUSIONS
  Nonunion and deep infections occur commonly after staged open reduction and internal fixation of high-energy tibial plateau fractures. Open fractures and open fasciotomy wounds at the time of internal fixation are associated with higher rates of infection.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors: Department of Orthopaedic surgery, Carolinas Medical Center, Charlotte, NC.
authors: Michael R
authors: MR
authors: Ruffolo
authors: Franklin K
authors: FK
authors: Gettys
authors: Harvey E
authors: HE
authors: Montijo
authors: Rachel B
authors: RB
authors: Seymour
authors: Madhav A
authors: MA
authors: Karunakar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D003161:Compartment Syndromes / Q000150:complications / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects; D005597:Fractures, Open / Q000150:complications / Q000601:surgery*; D005599:Fractures, Ununited / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology*; D013978:Tibial Fractures / Q000150:complications / Q000601:surgery*; D055815:Young Adult