High Energy Proximal Tibial Fractures at Landspítali University Hospital 2003-2021 : Háorku nærendabrot á sköflungsbeini á Landspítala 2003-2021

Abstract

OBJECTIVE: The aim of this study was to investigate the epidemiology of proximal tibial fractures treated at Landspítali National University Hospital following high energy trauma. MATERIALS AND METHODS: This study reviewed patient records of individuals who sustained proximal tibial fractures and were treated at Landspítali between 2003 and 2021. Data on age, sex, mechanism of injury, treatment plan, hospital stay, and outcomes were recorded. Fracture classification was based on evaluation and imaging reviewed in the Agfa system and categorized using the Schatzker classification system. RESULTS: A total of 195 high energy proximal tibial fractures were identified during the study period. The mean age of patients was 42 years, and 62,1% were male. Traffic accidents were the most common mechanism of injury, followed by horse-related accidents and recreational injuries. Most fractures occured in June, and incidence was higher during the summer months. The most common fracture type was Schatzker type II (32,8%), with type I and VI also frequently observed. Surgical treatment was perfomed in 56,9% of cases, most commonly involving internal fixation with plates and screws (used in 74,8% of surgeries). Among those undergoing surgery, Schatzker type VI was the most common. Associated injuries were found in 31,2% of cases, most frequently in patients with complex Schatzker type VI fractures. Only one death occured in relation to the fractures (0,5%). Other complications, such as infections or thromboembolism, were rare. Twelve cases had undergone total knee arthroplasty by the end of the study period. CONCLUSIONS: The incidence of proximal tibial fractures in Iceland (2003-2021) has increased and is comparable to reports from neighboring countries. These injuries are most common in middle-aged men and often result from high energy trauma. Traffic accidents were the leading cause, followed by horse-related and recreational injuries. Most patients who sustained high energy proximal fractures underwent surgery.