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General Orthopaedics

MAJOR TRAUMA CENTRE STATUS AFFECTS THE PRESENTATION AND EPIDEMIOLOGY OF TIBIAL PLATEAU FRACTURES: DOES THIS HAVE IMPLICATIONS FOR TRAINING TOMORROW'S MILITARY TRAUMA SURGEONS?

The Combined Services' Orthopaedic Society (CSOS), 37th Annual Meeting, Derriford, England, May 2016.



Abstract

Tibial plateau fractures classically present in a bimodal distribution associated with high energy mechanisms in the younger population and fragility fractures in the elderly populations as a result they are well suited for looking at the effect major trauma centre status. Military trauma surgeons in training should be exposed to as much young high-energy trauma as possible to equip them for operations.

Retrospective review of all tibial plateaus presenting to RVI 20 months before MTC status and 20 months following this.

61 patients pre, 66 post. Schatzker grade 1–4 were similar pre and post change. Post change there was an increase in Schatzker 5 (62%) and 6 (27%). High energy injuries were most common in younger males, cause was falls followed by RTAs.

MTC status has meant an increase in high energy tibial plateaus (Schatzker 5–6) These were predominantly seen in younger males with high-energy mechanisms. As this is likely to be replicated across all injuries, we would recommend military trauma surgeons have a significant period of time training in major trauma centres to ensure adequate exposure to young high energy trauma.