Does the mode of fixation of tibial plateau fractures, i.e. external fixation versus internal fixation influence the time to union? A systematic review of the literature

Charlie Lewis

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Abstract

Introduction  

Tibial, plateau fractures are common yet challenging injuries seen by the orthopaedic surgeon. The goal of therapy is to reduce the fracture and begin early mobilisation. Various techniques can be employed to achieve this. The aim of our study was to ascertain whether the mode of fixation influenced the time to union.

Method  

The current literature was systematically reviewed according to eligibility criteria to ascertain whether internal versus external fixation of tibial plateau fractures influenced the time to union.

Results  

Nine studies met the eligibility criteria. From the nine there does not appear to be a significant difference between the time bony union between the two treatment modalities. The approximate time seems to be around 4 months. The arthoscopically assisted internal fixation technique seemed to achieve bony union in a slightly reduced mean time frame of 12 weeks with a relatively narrow range 11–14 weeks.

Conclusion  

There does not appear to be a significant difference in the time to union between the two treatment modalities. Given the current level of evidence, further studies (preferably randomised controlled prospective trials) are required in order to fully ascertain the full effect of whether the mode of fixation influences the time too union.

Keywords  Tibial plateau - Fractures - External fixation - Internal fixation - Union

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