European Journal of Orthopaedic Surgery & Traumatology

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Open Access 09-05-2024 | Tibial Plateau Fracture | Original Article

Subchondral rafting wires reduce tibial plateau fracture subsidence

Authors: Joseph T. Patterson, Daniel Rusu, Andrew M. Duong, Vivek Satish, Max Yang, Lucas Mayer, Michael Allen, Geoffrey S. Marecek

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 5/2024

Abstract

Purpose

To determine if subchondral rafting wires retained as adjunctive tibial plateau fracture fixation affect postoperative articular subsidence.

Methods

A retrospective cohort study was conducted at one Level 1 trauma center and one academic university hospital. Consecutive adults with closed, displaced OTA/AO 41B/C tibial plateau fractures treated between 2018 and 2023 with open reduction internal fixation were included. Patients who were not ambulatory, with contralateral injuries limiting weight bearing, and without follow-up radiographs of the injured extremity were excluded. The intervention was retention of subchondral rafting wires as definitive fixation. The primary outcome was linear articular surface subsidence between postoperative and follow-up AP knee radiographs. Linear subsidence was compared between groups using Welch’s two sample t test. Associations of linear subsidence with patient, injury, and treatment characteristics were assessed by multivariable linear regression.

Results

We identified 179 patients of a mean age of 44 ± 14 years, of whom 15 (8.4%) received subchondral rafting wires. Median follow-up was 121 days. No patients who received rafting wires as definitive implants experienced linear subsidence ≥ 2 mm, while 22 patients (13.4%) who did not receive rafting wires experienced linear subsidence ≥ 2 mm (p = 0.130). Subchondral rafting wires were associated with less linear subsidence (0.3 mm [95% confidence interval − 0.3–0.9 mm] vsersus 1.0 mm [− 0.9–2.9 mm], p < 0.001). The depth of linear subsidence was significantly associated on multivariable regression with male sex, depressed plateau area, active smoking, and retained rafting wires.

Conclusion

Subchondral rafting wires were associated with a small reduction in articular subsidence after internal fixation of tibial plateau fractures. Routine rafting wires may be useful for patients and fractures at high risk of articular subsidence.

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Title: Subchondral rafting wires reduce tibial plateau fracture subsidence
Authors: Joseph T. Patterson
Daniel Rusu
Andrew M. Duong
Vivek Satish
Max Yang
Lucas Mayer
Michael Allen
Geoffrey S. Marecek
Publication date: 09-05-2024
Publisher: Springer Paris
Keyword: Tibial Plateau Fracture
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 5/2024
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-024-03963-1

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Abstract

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Primary arthrodesis for diabetic ankle fractures using a modified retrograde femoral intramedullary locking nail combined with lateral plating, surgical technique, and early results of a pilot study

Frailty is a predictor of immediate postoperative complications following surgical management of knee dislocations

Unclassified acetabular fractures: Do they really exist?

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