Open reduction and internal fixation is the gold standard treatment for tibial plateau fractures. However, the procedure is not free of complications such as knee stiffness, acute infection, chronic infection (osteomyelitis), malunion, non-union, and post-traumatic osteoarthritis. The treatment options for knee stiffness are mobilisation under anaesthesia (MUA) when the duration is less than 3 months, arthroscopic release when the duration is between 3 and 6 months, and open release for refractory cases or cases lasting more than 6 months. Early arthroscopic release can be associated with MUA. Regarding treatment of acute infection, if the fracture has healed, the hardware can be removed, and lavage and debridement can be performed along with antibiotic therapy. If the fracture has not healed, the hardware is retained, and lavage, debridement, and antibiotic therapy are performed (sometimes more than once until the fracture heals). Fracture stability is important not only for healing but also for resolving the infection. In cases of osteomyelitis, treatment should be performed in stages: aggressive debridement of devitalised tissue and bone, antibiotic spacing and temporary external fixation until the infection is resolved (first stage), followed by definitive surgery with grafting or soft tissue coverage depending on the bone defect (second stage). Intra-articular or extra-articular osteotomy is a good option to correct malunion in young, active patients without significant joint damage. When malunion is associated with extensive joint involvement or the initial cartilage damage has resulted in knee osteoarthritis, the surgical option is total knee arthroplasty.

中文翻译：

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胫骨平台骨折手术治疗的并发症：患病率、原因和处理。

切开复位内固定是胫骨平台骨折治疗的金标准。然而，该过程并非没有并发症，例如膝关节僵硬、急性感染、慢性感染（骨髓炎）、畸形愈合、不愈合和创伤后骨关节炎。膝关节僵硬的治疗选择是持续时间小于 3 个月的麻醉下活动（MUA），持续时间为 3 至 6 个月的关节镜松解术，以及持续时间超过 6 个月的难治性病例的开放松解术。早期关节镜松解可能与 MUA 有关。对于急性感染的治疗，如果骨折愈合，可以取出内固定物，同时进行灌洗和清创，同时进行抗生素治疗。若骨折未愈合，则保留硬件，并进行灌洗、清创、和抗生素治疗（有时不止一次，直到骨折愈合）。骨折稳定性不仅对愈合很重要，而且对解决感染也很重要。在骨髓炎的情况下，治疗应分阶段进行：积极清创失活的组织和骨骼，抗生素间隔和临时外固定直到感染解决（第一阶段），然后根据骨骼进行移植或软组织覆盖的确定性手术缺陷（第二阶段）。关节内或关节外截骨术是矫正年轻活跃患者畸形愈合的良好选择，且没有明显的关节损伤。当畸形愈合伴有广泛的关节受累或最初的软骨损伤导致膝关节骨关节炎时，手术选择是全膝关节置换术。