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. 2020 Dec 19:16:143-148.
doi: 10.1016/j.jcot.2020.12.017. eCollection 2021 May.

Characteristics, Treatments, and Outcomes of Tibial Plateau Nonunions: A Systematic Review

Kyle K Obana  1 , Gordon Lee  1 , Lorrin S K Lee  1
Affiliations

Characteristics, Treatments, and Outcomes of Tibial Plateau Nonunions: A Systematic Review

Kyle K Obana et al. J Clin Orthop Trauma. .

Abstract

Background: Due to the rare incidence of tibial plateau nonunions, current studies are limited to small sample sizes and patient demographics. The aim of this systematic review is to quantify and report patient and fracture traits, possible risk factors, and treatment outcomes of tibial plateau nonunions.

Methods: PubMed, Clinical Key, and MEDLINE were searched for articles published prior to August 2020 in accordance to the preferred reporting items for systematic reviews and meta-analyses (PRISMA). The authors used varying combinations of the following terms to identify relevant articles: "tibial," "plateau," "nonunion," "non-union." Studies were assessed for patient demographics, pre-revision nonunion characteristics, treatment, and post-revision outcomes.

Results: Eight studies were included, yielding 31 tibial plateau nonunions (21 males, 10 females). The majority of nonunions were associated with high energy trauma (52.2%) and were Schatzker class VI (54.8%). Schatzker class I and II nonunions were not attributed to neglect, contradicting previous suggestions. Time to union was 4.0 months, the most common treatments being autologous bone grafting (76.7%) and revision plating (63.3%).

Conclusion: This study demonstrates the effectiveness of autologous bone grafts and revision plating for tibial plateau nonunions. Physicians may use these findings to guide decision making in the event of high energy plateau nonunions. Lastly, various limitations exist within the current literature, emphasizing the need for standardized reporting measures.

Keywords: Fracture; Nonunion; Schatzker; Tibial plateau; Trauma.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram.
Fig. 2
Fig. 2
AP and lateral radiographs significant for lateral tibial plateau and fibular neck fractures following a motor vehicle accident.
Fig. 3
Fig. 3
AP and lateral radiographs demonstrating nonunion and malreduction of plateau fragment (arrow) at six months following ORIF using arthroscopy-assisted reduction with cannulated screws.
Fig. 4
Fig. 4
Three-year follow-up demonstrating healing of nonunion following revision plating with bone grafts.
See this image and copyright information in PMC

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