Managing Complications After Tibial Plateau Fractures: A Temporal Framework-Based Narrative Review.

Abstract

Tibial condyle fractures are often challenging to manage. These are frequently associated with complications, which can affect long-term knee function. This study aims to categorize these complications based on their timing and provide an overview of their prevention and management. A narrative review was conducted by searching PubMed, Scopus, and Web of Science databases for studies published between January 2000 and March 2025. Relevant articles discussing complications following tibial condyle fractures were selected and analysed. Complications were grouped into early (within 2 weeks), intermediate (2 weeks to 3 months), and late (after 3 months) stages. Sixty-three studies were included on complications after tibial plateau fractures. Complications were categorized temporally as early (wound issues, compartment syndrome, infection), intermediate (persistent infection, fixation failure, stiffness), and late (malunion, nonunion, osteoarthritis). Management strategies varied by stage, emphasizing timely recognition, prevention, and appropriate intervention to optimize outcomes. Early complications included wound breakdown, compartment syndrome, and early infections. Intermediate complications involved persistent infection, implant-related issues, and arthrofibrosis. Late complications included nonunion, malunion, chronic osteomyelitis, stiffness, and post-traumatic arthritis. Advances in fracture classification, imaging, staged fixation strategies, and improved soft tissue management have contributed to reduced complication rates and better outcomes. Management of tibial condyle fractures has evolved with a better understanding of soft tissue handling, fracture patterns, and the importance of early mobilization. Classifying complications by timing helps guide clinical decisions and improve patient outcomes. Despite advancements, complications remain a concern, especially in high-energy trauma or delayed presentations. The online version contains supplementary material available at 10.1007/s43465-025-01651-8.