Functional assessment and outcome following surgical treatment of displaced tibial plateau fractures: a retrospective analysis

• Published in: European journal of trauma and emergency surgery (Munich : 2007) 2023-12, Vol.49 (6), p.2373-2379
• Main Authors: Gahr, Patrick, Mittlmeier, Thomas, Grau, Anja, Herlyn, Philipp K. E., Rahn, Anja, Fischer, Dagmar-C.
• Format: Article
• Language: English
• Subjects: Adult; Critical Care Medicine; Emergency Medicine; Fracture Fixation, Internal - methods; Fractures; Hip joint; Humans; Intensive; Medicine; Medicine & Public Health; Original; Original Article; Orthopedics; Patients; Quality of Life; Questionnaires; Retrospective Studies; Sports Medicine; Surgery; Surgical Orthopedics; Surgical outcomes; Surgical techniques; Tibial Fractures - surgery; Tibial Plateau Fractures; Traumatic Surgery; Treatment Outcome
• ISSN: 1863-9933; 1863-9941
• DOI: 10.1007/s00068-023-02401-x

Purpose Patients with tibial plateau fractures (TPF) are at risk of long-term hampered bipedal locomotion. A retrospective single-center study using patient-related outcome measures and a sophisticated assessment of walking abilities was conducted. Methods Adults receiving surgical treatment of an isolated TPF between January 2012 and December 2016 received the KOOS questionnaire together with the invitation for an extensive follow-up examination on the clinical outcome including standardized assessment of the walking abilities (loadsol ® system). Outcome was assessed relative to the severity of the injury or time to follow-up. Fractures were classified according to AO/OTA and Luo, respectively. Results 58 out of 132 eligible patients filled in the questionnaire and participated at a median follow-up of 3.05 years after injury. For the categories “pain”, “mobility”, and “daily life activities”, all patients were rather satisfied and this was virtually not related to the time between fracture and assessment. Relevant limitations were reported for “sports and recreational activities” and “quality of life”. Loading of the previously fractured leg was most evidently changed on stairs and outdoor walking. Outcome was not related to either fracture type severity or time from injury. Conclusion Outcome after an isolated TPF is neither related to fracture type, severity of the fracture nor time from injury. Simple gait analysis techniques relying on different tasks appear to yield a more sophisticated image on functional deficits after TPF than classical exam of ground-level walking and correlate quite well with validated patient-related outcome measures as the KOOS.