title: Incidence, Risk Factors, and Location of Articular Malreductions of the Tibial Plateau.
abstract: OBJECTIVE
  To define the incidence, risk factors, and anatomic location of articular malreductions in operatively treated lateral tibial plateau fractures.
  
  
  METHODS
  Prospective Cohort Study.
  
  
  METHODS
  Academic Level 1 Trauma Centre.
  
  
  METHODS
  Study subjects were patients entered into a prospective cohort study of tibial plateau fractures.
  
  
  METHODS
  Surgical fixation of tibial plateau fractures and postoperative computed tomographies (CTs).
  
  
  METHODS
  The primary outcome was incidence of articular malreduction. Secondary outcomes included risk factors for malreduction and a descriptive analysis of malreduction location.
  
  
  RESULTS
  Sixty-five postoperative CTs were reviewed. Twenty-one reductions (32.3%) had a step or gap more than 2 mm. The frequency of malreductions in patients undergoing submeniscal arthrotomy or fluoroscopic-assisted reduction alone was 16.6% and 41.4%, respectively (P = 0.0021). Age, body mass index, OTA/AO fracture type, operative time, use of bone graft or bone graft substitute, and use of locking plates were not predictive of malreduction. Malreductions were heavily weighted to the posterior quadrants of the lateral tibial plateau.
  
  
  CONCLUSIONS
  When examined using cross-sectional imaging the rate of articular malreductions was high at 32.3%. Fluoroscopic reduction alone was a predictor for articular malreduction. Most malreductions were located in the posterior quadrants of the lateral plateau.
  
  
  METHODS
  Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Division of Orthopedic Surgery, University of Ottawa, Ottawa, ON, Canada; and †University of Calgary, Cumming School of Medicine, Section of Orthopaedic Surgery, Calgary, AB, Canada.
authors.forename: Brad
authors.initials: B
authors.lastname: Meulenkamp
authors.forename: Ryan
authors.initials: R
authors.lastname: Martin
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Desy
authors.forename: Paul
authors.initials: P
authors.lastname: Duffy
authors.forename: Rob
authors.initials: R
authors.lastname: Korley
authors.forename: Shannon
authors.initials: S
authors.lastname: Puloski
authors.forename: Richard
authors.initials: R
authors.lastname: Buckley
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D016025:Bone Transplantation / Q000706:statistics & numerical data*; D002170:Canada / Q000453:epidemiology; D015984:Causality; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005593:Fracture Fixation, Internal / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007593:Joint Instability / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D011379:Prognosis; D012307:Risk Factors; D017678:Sex Distribution; D013978:Tibial Fractures / Q000453:epidemiology* / Q000601:surgery*; D016896:Treatment Outcome