Tibial Plateau Fracture: Infection, Failure of Fixation, and Instability

Infection following fixation of tibial plateau fractures can be related to patient factors (eg, diabetes, smoking, malnutrition, systemic disease); medications such as steroids; open fractures; high-energy injuries; and compartment syndrome. Surgeon-dependent variables, such as timing of surgery and soft tissue handling, are also important. Tibial plateau fixation failure has been found to be associated with multiple factors, including age, osteoporosis, comminution, preoperative displacement, infection, soft tissue injuries (specifically medial collateral ligament), and noncompliance with weight-bearing restrictions. ^{1, 2} Residual instability despite anatomic reduction of the articular surface and restoration of limb alignment can be the result of failed fixation and/or unaddressed soft tissue injuries.