CTA-detected incidence and descriptive fracture patterns of arterial injury in 539 surgically treated tibial plateau fractures.

BACKGROUND

Tibial plateau fractures (TPF) are complex injuries associated with significant soft tissue and periarticular complications. Although vascular injuries are well described in lower limb trauma, their incidence in tibial plateau fractures has not been clearly established.

METHODS

Retrospective cohort study including patients with surgically treated TPF at a level I trauma center between 2016 and 2024. CTA was selectively performed based on clinical judgment. Post hoc descriptive risk scenarios were constructed to organize observed fracture patterns. Analysis was primarily descriptive.

RESULTS

539 surgically treated TPF were included. Mean age was 43.7 years (18-75), 73.84% were male. Left knee was affected in 54.92%. High-energy trauma accounted for 70.87%. The CTA yield was 3.66% (6/164), corresponding to an overall observed incidence of 1.11% (6/539). Certain fracture patterns and clinical scenarios were more frequently observed among cases with arterial injury; however, these observations are based on very few events and should be interpreted cautiously as descriptive findings only.

CONCLUSION

The CTA-detected incidence of arterial injury in this series of surgically treated tibial plateau fractures was 1.11%. Certain fracture patterns and clinical contexts were observed among the small number of cases with arterial injury; however, these findings are descriptive and should be interpreted as hypothesis-generating.