Prospective cohort study of 41 patients with depressed tibial plateau fractures asking whether the amount of residual articular depression — measured on coronal tomogram and stratified as <2.5 mm, 2.5–5 mm, or ≥5 mm — predicts functional and clinical outcomes at an average of 3.9 years after injury, and whether mechanical axis restoration matters independently.
When fixing a depressed tibial plateau fracture, prioritize articular reduction over mechanical axis correction — the data show that residual depression under 2.5 mm translates to meaningfully better range of motion and validated knee scores at nearly 4 years, while limb alignment has little bearing on most functional outcomes.
Use submeniscal arthrotomy, intraoperative arthroscopy, or arthrogram to confirm your reduction before closing.
Prospective cohort study of 41 patients with depressed tibial plateau fractures asking whether the amount of residual articular depression — measured on coronal tomogram and stratified as <2.5 mm, 2.5–5 mm, or ≥5 mm — predicts functional and clinical outcomes at an average of 3.9 years after injury, and whether mechanical axis restoration matters independently.
When fixing a depressed tibial plateau fracture, prioritize articular reduction over mechanical axis correction — the data show that residual depression under 2.5 mm translates to meaningfully better range of motion and validated knee scores at nearly 4 years, while limb alignment has little bearing on most functional outcomes.
Use submeniscal arthrotomy, intraoperative arthroscopy, or arthrogram to confirm your reduction before closing.