Tibial plateau fractures

Six patients had lateral tibial plateau fracture. In 2 of these there was avascular necrosis of the elevated tibial plateau. In 1 patient, a plateau was elevated twice and there was nonunion. One patient suffered sepsis in the knee. This left 2 uncomplicated lateral tibial plateau fractures, and of these 1 had occurred 37 years before the knee replacement. My study suggests counterintuitively that tibial plateau fractures, especially those of the lateral tibial plateau, seldom progress to total knee replacement unless there are surgical complications.