Effect of age and analysis of prognostic risk factors in the treatment of complex tibial plateau fracture

Introduction: ： The primary aim is to compare the t complex tibial plateau fractures（CTPFs）treated with open reduction internal fixation（ORIF）between elderly (age≥55 years) and young(age＜55 years) patients. The second aim is to investigate the risk factors in the treatment of CTPFs. Material: and Method： Patients who received double-incision approaches for CTPFs between November 2016 and December 2020 were collected retrospectively. The treatment effect was assessed by operation time、lower limb alignment、non-anatomical reduction of the articular surface、infection rate、hospital for special surgery knee score（HSS） and range of motion（ROM）. We defined treatment failure as either the HSS＜75 or the ROM＜100° in the last follow-up and performed a multivariable logistic model to identify the risk factors for treatment failure. Result: ： There were no differences between the groups in terms of demographics except for diabetes（P=0.012）. We detected no differences in the variables of treatment evaluation except the HSS(P=0.0001) and ROM(P=0.001). While the value of HSS and ROM in the elderly was still as high as 82.21±7.29 and 114.00±14.64° respectively. Age≥55 yeas（P=0.001）、tobacco use（P=0.012）、non-anatomical reduction of the articular surface（P=0.036） were risk factors for treatment failure. Conclusions: ： ORIF combined with double-incision was still suitable for most elderly patients. In addition to focusing on the surgical treatment, attention should also be paid to the patients' personal habits.