Evidence map›Paper›PMID 42525129›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2026

Tibial tubercle involvement in tibial plateau fractures is associated with nonunion, reoperation, and flexion deficits.

Robert G Hernandez, David Dallas-Orr, Noah L Lyndall, Tyler E Lockwood, Shannon Tse, Gillian L S Soles, Ellen P Fitzpatrick, Mark A Lee, Sean T Campbell, Augustine M Saiz

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In one paragraph

Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Letter to the editor: methodological considerations regarding tibial tubercle involvement in tibial plateau fractures.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026
    Article
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Robert G HernandezSchool of Medicine, University of California, Davis, Sacramento, USA.
David Dallas-OrrDepartment of Orthopaedic Surgery, University of California Davis Medical Center, Sacramento, USA. drdaviddallasorr@gmail.com.
Noah L LyndallSchool of Medicine, University of California, Davis, Sacramento, USA.
Tyler E LockwoodSchool of Medicine, University of California, Davis, Sacramento, USA.
Shannon TseDepartment of Orthopaedic Surgery, University of California Davis Medical Center, Sacramento, USA.
Gillian L S SolesDepartment of Orthopaedic Surgery, University of California Davis Medical Center, Sacramento, USA.
Ellen P FitzpatrickDepartment of Orthopaedic Surgery, University of California Davis Medical Center, Sacramento, USA.
Mark A LeeDepartment of Orthopaedic Surgery, University of California Davis Medical Center, Sacramento, USA.
Sean T CampbellDepartment of Orthopaedic Surgery, University of California Davis Medical Center, Sacramento, USA.
Augustine M SaizDepartment of Orthopaedic Surgery, University of California Davis Medical Center, Sacramento, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTibial tubercle involvement (TTI) in tibial plateau fractures (TPF) is understudied. We evaluated whether TTI is associated with major postoperative complications and range-of-motion (ROM) recovery after operative TPF compared with isolated TPF (iTPF).

methodsWe performed a retrospective cohort study of operatively treated TPFs from 2014 to 2025. TTI was identified using radiographs, CT scans, and operative reports. Primary outcomes were knee ROM (flexion and extension) at 6 weeks, 12 weeks, and 1 year, as well as postoperative complications including reoperation and nonunion. Covariates included demographics, injury and operative characteristics, complications, and postoperative weight-bearing/immobilization status.

resultsAmong 132 TPFs, 38 (28.6%) had TTI and 94 (71.2%) were iTPF, with similar baseline age, BMI, sex, and ISS. TTI injuries were more frequently Schatzker VI and open, whereas iTPF were more commonly Schatzker II. Weight-bearing prescriptions were similar, but immobilization was more frequent with TTI. Compared with iTPF, TTI was not associated with significantly different flexion at 6 weeks, but was associated with lower flexion at 12 weeks (adjusted difference - 27.31°, 95% CI [- 37.73, - 16.88]; p < 0.001) and at 1 year (adjusted difference - 19.94°, 95% CI [- 35.41, - 4.48]; p = 0.011). Extension recovery did not differ over time. In the cohort with ≥ 3-month follow-up, TTI was associated with higher reoperation (39.4% vs. 11.2%, p = 0.001), nonunion (15.2% vs. 2.5%, p = 0.022), and culture-positive infection requiring reoperation (30.3% vs. 10.0%, p = 0.011). In adjusted analysis, TTI remained associated with any reoperation (OR 3.95, 95% CI [1.36, 11.48]; p = 0.012).

conclusionTTI was associated with higher rates of nonunion and reoperation after operative treatment of TPF, and with reduced flexion ROM at both 12 weeks and 1 year. However, these findings should be interpreted in the context of greater injury severity and more frequent postoperative immobilization in the TTI cohort.

Indexed as

Fracture Fixation, InternalFractures, UnunitedPostoperative ComplicationsReoperationTibial FracturesTibial Plateau FracturesAdultAgedFemaleHumansMaleMiddle AgedRange of Motion, ArticularRetrospective StudiesTibiaWeight-BearingOrthopedic surgeryRange of motionRehabilitationTibial plateau fracturesTibial tubercle

Identifiers

PMID42525129
PMCPMC13421266

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.