Functional Outcome of Patients Following Intra-articular Tibal Plateau Fractures

https://doi.org/10.25143/rsu-bjcmr.2024.01.045-052

Abstract

Introduction. Tibial plateau fractures are injuries that often require surgical treatment due to their complexity. The management of these fractures can be challenging and may lead to complications and functional impairment, impacting daily activities significantly.

Aim of the study. The aim of this study was to evaluate of the functional outcome of patients with intra-articular tibial plateau fractures following surgical treatment and to compare the functional outcome between low-energy and high-energy trauma patients following surgical treatment of tibial plateau fractures.

Materials and methods. The study enrolled a total of 108 patients with proximal tibia fractures who were admitted to the Hospital of Traumatology and Orthopaedics between December of 2018 and December 2021. Among them, 88 patients (81,5%) underwent surgical treatment and were included in research groups. Fractures were evaluated using anteroposterior radiograph and computed tomography images and were categorized according to AO/OTA and Schatzker classifications. The patients were divided into two groups: Group A consisted of patients with low-energy trauma, and Group B included patients with high-energy trauma. Functional outcomes were assessed using the Lower Extremity Functional Scale (LEFS).

Results. The study assessed the functional outcome of 45 patients (51,1%) who underwent surgery between 11 and 43 months ago. Among them, Group A consisted of 30 patients with an average age of 54,4 years, and they achieved a mean LEFS score of 54,3 SD +/- 17. On the other hand, Group B included 15 patients with a mean age of 53,4 years, and their average LEFS score was 52 SD +/- 16,8. Statistical analysis using the Mann-Whitney test revealed no significant differences in the mean LEFS score between the two groups, U = 210,0, p = 0,718. When examining the individual activities covered within the LEFS assessment, there were no statistically significant differences observed between the two groups.

Conclusions. Our research findings suggest that, in patients with tibial plateau fractures resulting from low-energy and high-energy trauma, there is no significant difference in post-operative functional outcomes, as per the Schatzker classification of these fractures. This suggests that relying solely on the Schatzker classification may not be adequate for predicting functional outcomes. Factors beyond the appearance of the fracture on anteroposterior radiographs seem to wield substantial influence in determining functional outcomes.

Keywords. Tibial plateau fracture; Functional outcomes; Schatzker classification.