{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T13:45:25Z","timestamp":1792676725928,"version":"4.5.0"},"reference-count":21,"publisher":"SLACK, Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopedics"],"abstract":"\n Background:<\/jats:title>\n This study compared outcomes of bicondylar tibial plateau fractures treated with staged versus acute definitive fixation.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n A multicenter retrospective review at 3 academic level 1 trauma centers included adult patients treated surgically for bicondylar tibial plateau fractures, grouped by treatment strategy: staged fixation (external fixation followed by open reduction internal fixation [ORIF]) or acute ORIF within \u226472 hours, comparing quality of reduction and complications, including unplanned return to the operating room.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n A total of 96 patients were treated with staged ORIF (group 1) and 74 with acute ORIF \u226472 hours (group 2). Length of stay was longer (\n P<\/jats:italic>\n = .011) and incidence of complication higher in group 1 (31% vs 14%;\n P<\/jats:italic>\n = .013). Wound dehiscence and drainage were significantly higher in group 1; concomitant compartment syndrome and wound vacuum-assisted closure were also highest in this group. There were no differences in AO\/OTA classification across groups (\n P<\/jats:italic>\n = .13); however, more complex fractures were associated with infection (\n P<\/jats:italic>\n = .026) and longer delays to definitive surgery (\n P<\/jats:italic>\n = .046). Quality of reduction was similar between groups. Patients in group 2 were less frequently treated definitively with >1 plate (16% vs 84%;\n P<\/jats:italic>\n < .001). Those treated with >1 plate had higher incidence of any complication (14% vs 44%;\n P<\/jats:italic>\n < .001). On backwards logistic regression, patients treated with early definitive fixation were 65% less likely to have any complication (\n P<\/jats:italic>\n = .022). Any complication, osteoporosis, and cerebrovascular disease significantly increased risk of unplanned return to the operating room.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Early definitive ORIF is safe for select bicondylar tibial plateau fractures.<\/jats:p>\n <\/jats:sec>","DOI":"10.3928\/01477447-20260904-01","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T13:31:28Z","timestamp":1792675888000},"page":"1-9","source":"Crossref","is-referenced-by-count":0,"title":["Complications in Acute Versus Delayed Definitive Fixation of Bicondylar Tibial Plateau Fractures"],"prefix":"10.3928","author":[{"given":"Ellen","family":"Lutnick","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Sports Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Ghanem","sequence":"additional","affiliation":[{"name":"The Johns Hopkins Hospital Department of Orthopaedic Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza M.","family":"Raja","sequence":"additional","affiliation":[{"name":"Henry Ford Hospital Department of Orthopedic Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Spath","sequence":"additional","affiliation":[{"name":"Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie J.","family":"Bousleiman","sequence":"additional","affiliation":[{"name":"Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad","family":"Siler","sequence":"additional","affiliation":[{"name":"The Johns Hopkins University School of Medicine, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Freitag","sequence":"additional","affiliation":[{"name":"Wayne State University School of Medicine, Detroit, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Hannoudi","sequence":"additional","affiliation":[{"name":"Wayne State University School of Medicine, Detroit, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colton L.","family":"Clymer","sequence":"additional","affiliation":[{"name":"Wayne State University School of Medicine, Detroit, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Daher","sequence":"additional","affiliation":[{"name":"Wayne State University School of Medicine, Detroit, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Geiger","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Sports 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Campus, Charlotte, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Guthrie","sequence":"additional","affiliation":[{"name":"Henry Ford Hospital Department of Orthopedic Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babar","family":"Shafiq","sequence":"additional","affiliation":[{"name":"The Johns Hopkins Hospital Department of Orthopaedic 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