[Early surgical releases of complex Schatzker V and VI tibial plateau fractures: a retrospective cohort of the last five years].

Introduction: high-energy bicondylar tibial plateau fractures involve extensive soft tissue damage and present significant postoperative risks, such as infections, venous thrombosis, and compartment syndrome. There is controversy regarding whether to manage these fractures with definitive surgical intervention or by using an external fixator as part of a staged management approach.

Material and methods: this was a retrospective cohort study. Twenty-two patients with complex tibial plateau fractures were analyzed during the study period. Patients were assigned to three groups based on surgical management: group A (external fixator followed by definitive osteosynthesis), group B (definitive external fixator), and group C (definitive osteosynthesis). Sociodemographic variables, fracture type, and postoperative complications were evaluated, with statistical analysis used to compare outcomes.

Results: most fractures were closed and resulted from motor vehicle accidents. Surgery was performed at an average of 7.86 days, with definitive osteosynthesis being the most common treatment (54.5%). Complications such as thromboembolism and infections were reported, but there were no immediate postoperative complications. Fracture consolidation was achieved in 95% of patients, with an average range of motion of 102 degrees, with no significant differences between treatments.

Discussion: Schatzker V and VI fractures present significant challenges. Although fixation methods have their advantages and disadvantages, functional outcomes are positive with good consolidation and recovery of mobility.

Conclusion: the choice of fixation type and timing of intervention should be based on a comprehensive evaluation of the patient and the fracture, considering potential complications to ensure adequate rehabilitation.