Intraosseous Shelf Plate Fixation for Depressed Articular Fragments in Tibial Plateau Fractures: A Technical Trick and Case Series.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: S. T. Campbell is an AAOS committee member, OTA committee member, NSITE Medical stock options, Synthes paid consultant, Smith and Nephew paid consultant, Takeda pharmaceuticals research support. J. Earhart is a Zimmer unpaid consultant. L. S. Marchand is a Synthes paid consultant, AO trauma NA paid speaker. W. M. Ricci is an ambulatory surgery center development network support, Cable Fix support, CrookedFoot support, HS2 support, JEASO support, JOT editorial board, McGinley Orthopaedics support, OTA board member, OsteoCentric support, Primo MC support, Rockwood and Green editorial board, Smith and Nephew paid consultant and royalties, Wolters Kluwer financial support. The remaining authors have no funding or conflicts of interest to disclose. 9. Int Orthop. 2025 May;49(5):1245-1253. doi: 10.1007/s00264-025-06443-1. Epub 2025 Feb 18. Immediate weight-bearing after tibial plateau fractures internal fixation results in better clinical outcomes with similar radiological outcomes: a randomized clinical trial. Ibrahim MA(1), Moustafa MMA(2), Brismée JM(3), Farouk O(2), Abdelnasser MK(2), Said HG(2), Hooper TL(3), Abdelmegeed M(4)(5), Abdelkawi AF(2)(6). Author information: (1)Orthopedic Rehabilitation Unit, Department of Orthopedic and Trauma Surgery, Assiut University Trauma Hospital, Assiut University, Assiut, Egypt. mariam.a.ibrahim@med.aun.edu.eg. (2)Department of Orthopedic and Trauma Surgery, Assuit University Trauma Hospital, Faculty of Medicine, Assiut, Assiut, Egypt. (3)Center for Rehabilitation Research, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, Texas, Lubbock, USA. (4)Department of Orthopedic Physical Therapy, Faculty of Physical Therapy, Cairo University, Cairo, Cairo, Egypt. mohamed.abdelmageed@hofstra.edu. (5)Department of Allied Health and Kinesiology, School of Health Sciences, Hofstra University, New York, New York, USA. mohamed.abdelmageed@hofstra.edu. (6)Clinic for Orthopedics, Trauma, Shoulder Surgeries and EndoprostheticsRHÖN-KLINIKUM AG, Bad Neustadt, Germany. PURPOSE: To investigate the effects of adding immediate weight-bearing to tolerance into a post-operative rehabilitation program for surgically treated Tibial Plateau (TP) fractures on clinical and radiological outcomes. METHODS: A randomized control trial. 106 Patients were recruited following open reduction internal fixation (ORIF) TP fracture, with 54 patients meeting the criteria for inclusion. Patients were assigned randomly into one of two groups: (1) the traditional group (TG) and (2) the weight-bearing group (WG). The TG was given the non-weight-bearing (NWB) rehabilitation protocol for six weeks. The WG was allowed immediate weight-bearing, and the same therapeutic exercise program was given to both groups. The dependent variables, including clinical and radiological measurements, were recorded six weeks, three months, and six months after the surgery. RESULTS: A total of 45 patients (11 women and 34 men), with a mean age of 43 ± 14 years, completed the study. There were significant differences between groups in favor of the WG at 6-months for the total clinical Rasmussen score (p =.002) as well as for the pain (p =.005), walking capacity (p =.002), and knee ROM (p =.047). We found neither difference between groups regarding radiological CT- Scan and X-ray measures nor Rasmussen's radiological scores (p =.854). Fracture type (Schatzker I-IV) did not affect any radiological measures between the groups. Four of 45 patients had intra-articular collapse, three in TG and one in WG (p =.571). CONCLUSION: Immediate weight-bearing as tolerated after ORIF of TP fractures (Schatzker I-IV) resulted in better clinical outcomes with no significant differences in the radiological measures. © 2025. The Author(s). DOI: 10.1007/s00264-025-06443-1 PMCID: PMC12003496