title: Outcome of angular stable locking plate fixation of tibial plateau fractures Midterm results in 101 patients.
abstract: BACKGROUND
  Articular reconstruction and stable fixation of tibial plateau fractures and its various subtypes continue to represent a surgical challenge. Only few trials have studied results following angular stable plate fixation. The present study aimed to investigate the clinical, radiological, functional and quality of life results following tibial plateau fractures using angular stable plate fixation.
  
  
  METHODS
  101 patients were retrospectively studied using functional (ROM; KSS; VAS), radiographic (osteoarthritis score, loss of reduction) and quality of life (WOMAC; Lysholm) scores. There were 46 males and 55 females. The average of patients was 51 years (range 22-77 years). Study groups were assigned according to the AO fracture classification.
  
  
  RESULTS
  Mean followup was 57 ± 30 months. Fracture type distribution revealed a significantly (P < 0.001) increased number of type B- (62.4%) compared to C-fractures. Functional assessment showed a significantly better total KSS (84.1 ± 15.6 vs. 74.7 ± 18.0; P = 0.01) as well as ROM (active: 124°±17° vs. 116°±15°, P = 0.014; passive: 126°±18° vs. 118 ± 14°, P = 0.017) in the B-fracture group. VAS was found to be markedly higher (P = 0.0039) following type C-fractures. Rating osteoarthritis secondary to a tibial plateau fracture as a function of injury severity (r = 0.485; P < 0.001) and relating the loss of reduction to the grade of evolving osteoarthritis (r = 0.643; P < 0.001) a positive correlation was found. Quality of life showed significantly improved results for Lysholm score (P = 0.004) following B-fractures with low overall values for the WOMAC score.
  
  
  CONCLUSIONS
  Presented data provide sufficient evidence that anatomic restoration of tibial plateau fractures with angular stable plate fixation result in decreased loss of reduction and declined incidence of posttraumatic osteoarthritis, thereby providing acceptable mid to long term outcome.
authors.affiliation: Charité University Medicine Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Märdian
authors.affiliation: Charité University Medicine Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Landmann
authors.affiliation: Charité University Medicine Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Wichlas
authors.affiliation: Charité University Medicine Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Norbert P
authors.initials: NP
authors.lastname: Haas
authors.affiliation: Charité University Medicine Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Klaus-Dieter
authors.initials: KD
authors.lastname: Schaser
authors.affiliation: Charité University Medicine Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Schwabe
keywords: Angular stable locking plate; Bone fracture; bone plates; clinical results; fracture fixation; internal; osteosynthesis; radiologic results; tibia plataeu fracture; tibial fracture