Prevalence, Patterns and Associated Factors of Acute Tibia Plateau Fractures among Adults with Tibia Fractures in Uganda

Author(s): Benjamin Costantine Mfaume, Expeditho Mtisi, Samuel Bugeza, Patric Sali, Abdirizak Sheikdon, Emusugut Michael, Waiswa Gonzaga, Tonny Mutanda

Background: 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. Tibia Plateau fractures are associated with poor outcomes and more significant late complications if not well managed.

Objective: To determine the prevalence, patterns and associated factors of Tibia Plateau fractures (TPFs) among adults with tibia fractures seen at Mulago National Referral Hospital using Computerized tomography.

Methods: This was a cross sectional study which assessed tibia plateau fractures using computerized tomography. 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 independent association with tibia plateau fractures.

Results: 283 participants with tibia fractures were enrolled, 40 had tibia plateau fractures resulting in a prevalence of 14.1% (95% CI; 10.5 to 18.7). In this study 75% of the injuries involved the right tibia and 57.5% were closed injuries. Majority of tibia plateau fractures were classified as Schatzker VI at 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.