The outcome after lateral tibial plateau fracture treated with percutaneus screw fixation show a tendency towards worse functional outcome compared with a reference population

Eur J Trauma Emerg Surg. 2016 Apr;42(2):177-84. doi: 10.1007/s00068-015-0497-9. Epub 2015 Feb 13.

Abstract

Purpose: The objective of this study was to evaluate the functional and radiological outcome after lateral tibial plateau fractures (Müller AO classification (AO) 41-B1, B2 and B3) treated with minimal invasive bone tamp reduction and percutaneous screw fixation.

Methods: Retrospective, cross-sectional study. Review and clinical examination of 37 patients treated between 2005 and 2010. The patients completed a clinical examination, Knee Injury and Osteoarthritis Outcome Score (KOOS) and questionnaire evaluating QOL (Eq5D-5L).

Results: Thirty-seven patients agreed to participate (76 %). Mean time of follow-up was 5.2 years. At final follow-up, maintained anatomical joint reduction was achieved in 34 patients. The mean KOOS score was pain = 84.4, ADL = 88.4, symptoms = 80.7, QOL = 70.3, sport = 59.6. Compared with the established KOOS reference population patients, the current study reports a tendency towards worse KOOS scores but is only significant for KOOS sport. The mean Eq5D-5L index was 0.815 and shows a tendency towards worse outcome compared with the reference population. Mean knee flexion: 125.7° (95-135). A reduced number of sit-to-stands in the mean 30-s chair stand test showed a significant negative association with KOOS. The study showed a significant association between younger age at surgery and worse KOOS outcome.

Conclusion: At 5.2-year follow-up, the patients reported a tendency towards worse KOOS and Eq5D-5L scores compared with established reference populations. This study shows a significant association between a decrease in muscle strength and worse KOOS outcome. Furthermore, a significant association between younger age at the time of surgery and worse KOOS outcome score was observed.

Keywords: Minimal invasive surgery; Outcome; Patient-reported outcome; Tibial plateau fracture.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Bone Screws*
  • Cross-Sectional Studies
  • Denmark
  • Female
  • Fracture Fixation* / adverse effects
  • Fracture Fixation* / instrumentation
  • Fracture Fixation* / methods
  • Humans
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / adverse effects
  • Minimally Invasive Surgical Procedures / instrumentation
  • Minimally Invasive Surgical Procedures / methods
  • Patient Outcome Assessment
  • Quality of Life*
  • Radiography / methods
  • Recovery of Function*
  • Risk Factors
  • Tibia* / diagnostic imaging
  • Tibia* / injuries
  • Tibia* / surgery
  • Tibial Fractures* / diagnosis
  • Tibial Fractures* / physiopathology
  • Tibial Fractures* / psychology
  • Tibial Fractures* / surgery