Surgical fixation methods for tibial plateau fractures

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There is insufficient evidence to inform on the best method of surgical fixation or the best method of treating bone defects for tibial plateau fractures in adults. However, the available evidence from randomised trials does not contradict approaches aiming to limit soft-tissue dissection and damage or approaches aiming to limit autograft donor site complications through using bone substitutes.

Fractures of the tibial plateau account for 1% of all adult fractures. These injuries disrupt the lower surface of the knee joint and can result in bone defects. Surgical fixation is usually used for more complex fractures. Typically this involves open reduction and internal fixation with devices, typically plates and screws. Newer less invasive techniques include hybrid fixation comprising external fixation and limited internal fixation. Bony voids may be filled with bone graft (either allograft or autograft) or bone graft substitutes. This review aimed to assess the effects (benefits and harms) of different surgical interventions, and the use of bone void fillers, for treating tibial plateau fractures.

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