{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:24:18Z","timestamp":1783488258135,"version":"3.55.0"},"reference-count":7,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T00:00:00Z","timestamp":1549929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Tibial\u2010plateau fractures with depressed osteochondral fragments have a high incidence of articular subsidence post reduction. Locking plates aim to prevent this via \u2018raft\u2019 screws below the subchondral bone. However, differences in plate design and patient anatomy result in variability of screw position in relation to the fragments they are designed to support. We evaluate the effect of screw placement and articular subsidence with this fracture pattern.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study of operatively treated tibial\u2010plateau fractures with free osteochondral fragments was performed to determine if screw placement was correlated with articular subsidence. Primary outcome was the relationship between screw to joint distance and articular subsidence. Secondary outcomes were whether bicortical fixation, presence of bone graft, fracture characteristics and patient age was correlated with articular subsidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010eight of 309 tibial\u2010plateau fractures had depressed osteochondral fragments (22%). The average thickness of these fragments was 10.2 mm. Fractures with raft screws placed closer to the joint than the thickness of the osteochondral fragment were less likely to subside (1.8 versus 3.4\u2009mm; <jats:italic>P<\/jats:italic>\u2009=\u20090.02). The proportion of fractures with no radiographic subsidence was also greater in this cohort versus fractures with distal screw placement (33% versus 8%; <jats:italic>P<\/jats:italic>\u2009=\u20090.02). Articular comminution (<jats:italic>P<\/jats:italic>\u2009=\u20090.04) and female patients aged over 65\u2009years (<jats:italic>P<\/jats:italic>\u2009=\u20090.03) were associated with increased articular subsidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Fractures fixed with screws closer to the joint than the thickness of the osteochondral fragment were correlated with less articular subsidence. The \u2018screw\u2010joint distance\u2019 may help guide screw placement intra\u2010operatively.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.14978","type":"journal-article","created":{"date-parts":[[2019,2,13]],"date-time":"2019-02-13T01:07:20Z","timestamp":1550020040000},"page":"320-324","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Influence of screw to joint distance on articular subsidence in tibial\u2010plateau fractures"],"prefix":"10.1111","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2405-8034","authenticated-orcid":false,"given":"Xuan","family":"Ye","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery Australian Capital Territory Health, The Canberra Hospital  Canberra Australian Capital Territory Australia"},{"name":"Prince of Wales Clinical School The University of New South Wales  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawei","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Australian Capital Territory Health, The Canberra Hospital  Canberra Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana M.","family":"Perriman","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Australian Capital Territory Health, The Canberra Hospital  Canberra Australian Capital Territory Australia"},{"name":"Trauma and Orthopaedic Research Unit  Canberra Australian Capital Territory Australia"},{"name":"Medical School Australian National University  Canberra Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul N.","family":"Smith","sequence":"additional","affiliation":[{"name":"Medical School Australian National University  Canberra Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000762"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2017.11.014"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-011-1409-z"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-015-1639-9"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2017.10.033"},{"key":"e_1_2_7_7_1","first-page":"255","volume-title":"Harborview Illustrated Tips and Tricks in Fracture Surgery","author":"Gardner MJDR","year":"2010"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199507000-00012"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fans.14978","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.14978","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.14978","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.14978","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T23:10:28Z","timestamp":1694387428000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.14978"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,12]]},"references-count":7,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1111\/ans.14978"],"URL":"https:\/\/doi.org\/10.1111\/ans.14978","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,12]]},"assertion":[{"value":"2018-08-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}