Epidemiological Analysis Of Tibial Plateau Fractures In Adults In The Third Affiliated Hospital To Hebei Medical University From 2003 Through 2012

Objectives: Tibial plateau fractures belong to intra-articular fractures of the proximal tibia which is one of the common lower extremity fractures. It’s mostly caused by high-energy injury. These fractures may accompanied by varying degrees of compression and displacement of the articular surface and influence the accouplement of the knee joint, stability and movement. Currently researches on the characteristics of tibial plateau fracture in adult is less. We investigated the medical records of adults tibial plateau fractures in our hospital from 2003 through 2012 among 10 years, and compare the data between the first and second five years. Aiming at a more comprehensive understanding of the epidemiological characteristics of the tibial plateau fractures in adult.Methods: Use the Picture Archiving and Communication Systems(PACS) to consult the medical records of all fractures in adult patient who is diagnosed or treated in the third affiliated hospital to Hebei medical university from January 2003 to December 2012. Inclusion criteria: fresh fractures, older than 16 years of age. Exclusion criteria: skull, mandible, ribs, sternum fracture, pathological fracture, periprosthetic fracture, old fracture. Type all the sifted X-ray films according to AO classification.All patients will be grouped by age: 16 to 20 years is a group, 21 to 80 years every 10 years is a group, more than 81 years is a group. Totalize and compare the number and constituent ratio of fractures in each group. Type all the adult tibial plateau fractures into typeⅠ, Ⅱ, Ⅲ, Ⅳ, Ⅴ, Ⅵ according to Schatzker classification[5]. Divide the fractures into type 41-B and 41-C according to AO classification[6]. Set the patient treated from January 2003 to December 2007[2,3] as group A, while the patient treated from January 2008 to December 2012 as group B. Compared the data between two groups.In this study, enumeration data were shown as cases and percentage. Use statistical software SPSS 19.0 to analysis the data. Chi-square test was used to compare the enumeration data such as gender, age and constituent ratio of fracture types between two groups. P<0.05 was considered as significant different.Results: 107,648 cases of fractures, 18,432 cases of tibia and fibula fractures, 3655 cases of proximal tibial fractures and 2004 cases of tibial plateau fractures in adult were treated by the Third affiliated Hospital to Hebei Medical University from January 2003 to December 2012 among 10 years. Tibial plateau fractures in adult accounted for 1.86 percent of all adult fractures, 10.87 percent of tibia and fibula fractures, 54.83 percent of proximal tibial fractures. Men 1425 cases(71.11%), female 579 cases(28.89%), male to female ratio was 2.5:1. The proportion of patients aged 41-50 was the highest(25.65%). The most frequent fracture type is 41-B(67.91%) according to AO classification, while type Ⅵ is the most frequent fracture type(22.31%) according to Schatzker classification.There are 1033 cases in group A, accounting for 1.86 percent of all adult fractures(1033/55423), 10.09 percent of adult tibia and fibula fractures(1033/10234), 54.11 percent of adult proximal tibial fractures(1033/1909). 752 cases were male, female 281 cases. 250 cases were over 50 years old(24.20%). There are 971 cases in group B, accounting for 1.86 percent of all adult fractures(971/52225), 11.84 percent of adult tibia and fibula fractures(971/8198), 55.61 percent of adult proximal tibial fractures(971/1746). 673 cases were male, female 298 cases. 310 cases were over 50 years old(31.93%).Comparing the date between the first and second five years. the proportion of adult tibial plateau fracture in tibia and fibula fractures accounted for the same period increased from 10.09% to 11.84%(P < 0.001). No significant change in the constituent ratio of gender(P = 0.085). The constituent ratio of patients over 50 years of age increased from 24.20% to 31.93%(P <0.001). The proportion of fracture type AO 41-B in group B increased from 64.96% to 71.06% compared to group A. The fracture type AO 41-C was reduced from 35.04% to 28.94%(P = 0.003). The change of constituent ratio in Schatzker type Ⅱ, Ⅲ, Ⅳ, Ⅴ fractures have significant difference(P <0.001, P <0.001, P = 0.007, P <0.001).Conclusion: The current investigation about adult tibial plateau fracture treated in the third affiliated hospital to Hebei medical university from 2003 through 2012 has implied the epidemiological characteristics, which includes that the percentage accounting for all fractures in adult is 1.86. The percentage accounting for tibia and fibula fractures in adult is 10.87. The percentage accounting for proximal tibia fractures in adult is 54.83. More common in men, peak age of about adult tibial plateau fracture is 41-50 yeas old. Type 41-B were more common according to AO classification. Type Ⅵ were more common according Schatzker classification. The proportion of adult tibial plateau fracture in tibia and fibula fractures accounted for the same period, patients over 50 years of age, the constituent ratio of AO type 41-B and Schatzker type Ⅲ in the second five years were increased compared with the first five years.