Association Between Tibial Plateau Fractures and Bone Metabolic Status: A Prospective Observational Study.

BACKGROUND

Tibial plateau fractures are serious injuries affecting knee function and mobility. While typically associated with high-energy trauma, these fractures are increasingly observed in low-energy mechanisms, particularly among patients with compromised bone health.

OBJECTIVE

To investigate the relationship between tibial plateau fractures and bone health parameters, specifically focusing on vitamin D status and bone mineral density, and to determine if fracture classification correlates with metabolic bone disease indicators.

METHODS

A prospective observational study was conducted over 11 months at Evangelismos General Hospital in Athens, Greece. A total of 45 patients with tibial plateau fractures and 28 control patients with knee contusions were assessed. All participants underwent biochemical testing and dual-energy X-ray absorptiometry (DEXA) scanning. Fractures were divided using the Schatzker classification.

RESULTS

A total of 34 (75.6%) patients with tibial plateau fractures had vitamin D deficiency, and 14 (31.1%) were diagnosed with osteopenia. Osteopenia was significantly more prevalent in low-energy trauma patients (six among nine patients vs. eight among 36 patients in high-energy trauma; 66.7% vs. 22.2%, p = 0.017). However, no statistically significant correlation was found between fracture severity and metabolic markers.

CONCLUSION

A substantial proportion of patients with tibial plateau fractures exhibit suboptimal bone health, especially vitamin D deficiency and osteopenia. Routine metabolic screening is recommended, particularly for fractures caused by low-energy mechanisms.