title: Complications in the management of closed high-energy proximal tibial plateau fractures.
abstract: OBJECTIVE
  To report complications in the management of complex closed proximal tibial fractures.
  
  
  METHODS
  A retrospective study was conducted to analyze the infectious and noninfectious complications encountered in the management of high-energy Schatzker type V and VI tibial plateau fractures. All patients were treated at the level 1 trauma centre between January 2011 and March 2014. Sixty two patients were included in the study. The mean patient age was (43.16 ± 11.59) years with 60 males and 2 females. Infectious complications like superficial and deep infection, wound dehiscence, malalignment in the immediate postoperative period and in follow-up period were noted.
  
  
  RESULTS
  The overall complication rate was 30.65% (19 out of 62). Infectious complications were noted in 20.97% cases (13/62). In majority of the cases (8/13), superficial infection was seen which managed with regular dressing and antibiotic administration. The patients (5/13) who had developed deep-seated infection were subjected to repeated debridements, flap coverage, implant removal or amputation depending upon the host response. Thirteen patients had experienced noninfectious complications. Hardware related complications were noticed in six patients and four among them received a secondary procedure. Malalignment was observed in seven patients but only single patient underwent subsequent operative intervention.
  
  
  CONCLUSIONS
  Proximal tibial plateau fractures especially Shatzker type V and VI are associated with extensive soft tissue damage even in closed injuries. The complications encountered in the management of these fractures can be minimized with appropriate patient selection and minimal soft tissue dissection.
authors.affiliation: Department of Orthopaedics, GGS Medical College and Hospital, Punjab, India.
authors.forename: Kavin
authors.initials: K
authors.lastname: Khatri
authors.forename: Vijay
authors.initials: V
authors.lastname: Sharma
authors.forename: Darsh
authors.initials: D
authors.lastname: Goyal
authors.forename: Kamran
authors.initials: K
authors.lastname: Farooque
mesh_terms: D000328:Adult; D000071938:Fasciotomy; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects*; D005596:Fractures, Closed / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy*; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000601:surgery*