The journal of knee surgery
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We aimed to investigate the incidence of proximal fibula fractures in patients with tibial plateau fractures and to identify risk factors for such combined injuries. From January 2011 to December 2015, 354 patients with tibial plateau fractures who had been admitted to a level 1 trauma center were retrospectively evaluated by an orthopaedic trauma surgeon and two skeletal radiologists. Anteroposterior plain radiography and computed tomography (CT) were used to characterize the injuries, and the incidence of associated proximal fibula fractures was determined. ⋯ Logistic regression analysis indicated an increasing trend in the incidence of fibula fractures detected by the CT-based three-column classification system as follows: "age × sex > three columns > age > single posterior column > lateral column + posterior column > medial column + posterior column > medial column + lateral column > single lateral column > single medial column." Proximal fibula fracture associated with tibial plateau fracture is a common phenomenon worthy of attention. In women, age increases the likelihood of complex tibial plateau fractures, particularly those involving the posterolateral articular surface and diaphysis, as well as the likelihood of developing proximal fibula fractures. This s Level IV diagnostic study.
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Tibial plateau fractures account for approximately 8% of fractures in the elderly population. Treatment strategies in the elderly are similar to those for younger patients; however, practitioners must account for the elevated comorbidity burden in this population. To date, few studies have analyzed age-based outcomes in patients with tibial plateau fractures. ⋯ There was no difference in the arthroplasty conversion rate (4.8% elderly vs. 7.9% control, p = 0.755). While elderly patients presented with a greater comorbidity burden, they had equivalent or better short-term outcomes when compared with their younger peers when treated with open reduction and internal fixation (ORIF). Despite the recent interest in primary total knee arthroplasty for elderly patients with tibial plateau fractures, the results of this study suggest that elderly patients may respond well when treated with ORIF following a tibial plateau fracture.