Aims Medial tibial plateau fractures are frequently due to high-energy injuries, and can be difficult to manage and associated with a significant rate of postoperative complications. The goal of the study was to evaluate the epidemiology and results of management of medial tibial plateau fractures, and ascertain the factors influencing its outcomes. Methods The patient cohort comprised 143 patients with medial tibial plateau fractures treated over a period of six years. The groups were divided into medial tibial plateau fractures (B-type) and bicondylar tibial plateau fractures (C-type), according to the AO/Orthopaedic Trauma Association (OTA) classification and Schatzker classification. Patient information, including basic demographic details, duration of follow-up, mechanism of injury, comorbidities, management, and postoperative complications, was recorded. Analysis of these data was performed to evaluate outcomes and compare both fracture groups. Results Among 143 patients, C-type fractures (43%) were more often linked to high-energy trauma and comorbidities, though not statistically significant (p = 0.051). Both groups were primarily managed with open reduction and internal fixation (ORIF; C-type: 88.5%, B-type: 85.4%, p = 0.582), with 7% managed conservatively. Complications were comparable, but deep infections (13.1% vs 4.9%, p = 0.079) and compartment syndrome (3.3% vs 0%, p = 0.099) were more frequent in C-type. Although C-type fractures demonstrated a trend towards higher complication rates and more complex management, none of the observed differences reached statistical significance. The overall risk of complications did not vary significantly between the two groups (p = 0.639). Logistic regression revealed no significant predictors of fracture type ( R² = 0.050). Conclusion The outcomes of isolated medial tibial plateau fractures are comparable with those of bicondylar tibial plateau fractures, with similar complication rates. Although C-type fractures tended to be associated with higher-energy trauma and increased risks of deep infection and compartment syndrome, these differences were not statistically significant. While medial plateau fractures are often assumed to be less severe, they can be considered injuries of similar complexity to bicondylar patterns. Cite this article: Bone Jt Open 2026;7(3):340–347.
Sanmugam et al. (Mon,) studied this question.