Prevalence, patterns and associated factors of acute tibia plateau fractures among adults with tibia fractures seen at Mulago National Referral Hospital

Abstract

Introduction The tibia plateau makes up one of the most critical load bearing articular surface in the human body. An injury to this vital anatomic region affects knee alignment, stability and ultimately impairs functional mobility. TPFs are associated with poor outcomes and more significant late complications if not well managed. Main objective To determine the prevalence, patterns and associated factors of Tibia Plateau fractures (TPFs) among adults with tibia fractures seen at MNRH using Computerized tomography. Study methodology This was a descriptive cross sectional study which involved tibia plateau fractures assessed using computerized tomography. This study enrolled patients with tibia fractures less than four weeks old. Fractures of TPFs were classified according to Schatzker and column classification with the help of an external radiologist, independent of the study. The prevalence of tibia plateau fractures was determined as a proportion of tibia plateau fractures among all tibia fractures enrolled in the study. The patterns were determined as a proportion of a particular pattern among tibia plateau fractures. For factors associated with TPFs, we performed a Fisher’s exact test and factors with P-values less than 0.2 at bivariate were considered to have an association with TPFs. Results A total of 283 participants with tibia fractures were enrolled in the study of which 40 had tibia plateau fractures resulting in a prevalence of 14.1% (95% CI; OR 10.5 18.7. In this study 75% of the injuries involved the right tibia and 57.5% were closed injuries. At the scene of injury the most affected group were the motorcycle riders (58.3%) followed by pedestrians (16.7%) The majority of tibia plateau fractures were classified as Schatzker VI, 60.0%. The most common column classification was medial accounting for 40% while the lateral and posterior columns were equally distributed by 30.0% each. Sex of participant was found to have an independent association with TPFs. Conclusion Tibia plateau fractures are common injuries with a high prevalence in our setting. Road traffic accidents were the most common mechanism of injury affecting mainly motorcyclists and pedestrians. Shatzker VI and medial column is the most common fracture pattern in our setting. The most affected groups were motorcycle riders and pedestrians. There is an independent association between tibia plateau fracture patterns and sex.