Tibial plateau fracture natural history, complications and prognosis

If left untreated, majority of patients with tibial plateau fracture may progress to develop malunion and loss of range of motion of the knee. Common complications of tibial plateau fracture include knee stiffness, malunion, nerve injuries, and post traumatic arthritis. Prognosis is generally good, with most patients can resume their previous level of activity, including competitive sports.

• If left untreated, majority of patients with tibial plateau fracture may progress to develop malunion and loss of range of motion of the knee and early post traumatic arthritis.^[1][2]

• Complications can be divided into early and late.^[3][4][5][6]
• Most early complications can be viewed as biologic failures, whereas late complications are often associated with problems.

Early Complications

Early complications include the following:

• Compartment syndrome
• Vascular injuries
• Loss of reduction
• Swelling and wound-healing problems
• Infections
• Deep vein thrombosis
• Nerve injuries

Late Complications

Late complications include the following:

• Knee stiffness
• Knee instability
• Angular deformities
• Late collapse
• Nonunion
• Implant breakage
• Malunion
• Post traumatic arthritis

• Prognosis is generally good, with most patients can resume their previous level of activity, including competitive sports.^[7][8]
• Most patients will likely lose a few degrees of final flexion and extension, and possibly rotation as well; however, these limitations generally do not prevent full function.
• Some patients are unable to resume their prior level of functioning.
• All treatment approaches have a percentage of poor results, with decreased flexion and extension, prominent implants, ligamentous instability, and degenerative joint disease.

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