Lebensqualität und Arbeitsfähigkeit nach operativer Behandlung von Tibiakopffrakturen

Roßbach, Björn P.; Faymonville, Christoph; Müller, Lars Peter; Stützer, H.; Isenberg, J.

doi:10.1007/s00113-014-2618-z

Cited by 12 publications

(4 citation statements)

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“…Im eigenen Vorgehen wurden 3 Achsabweichungen (7,8 %) gesehen, wobei nur Fehlstellungen von > 10°berücksichtigt wurden. Die Berücksichtigung einer Achsabweichung "erst" ab 10°k ann als Schwäche der Studie angeführt werden; auch geringere Abweichungen sind in verschiedenen Studien gemessen worden [6][7][8].…”

Section: Ikdc-und Ed-5q-scoresunclassified

“…der Weichteile wie Kompartmentsyndrome, Weichteilschädigungen, Infektionen sind möglich; ihre Häufigkeit wird mit 10-40% angegeben [6][7][8], in älteren Arbeiten sogar bis zu 80 % [9]. Den Langzeitverlauf betreffen Bewegungseinschränkungen, Achsfehlstellungen mit einer Häufigkeit von 16-27 % [6][7][8], eine sich entwickelnde posttraumatische Arthrose mit bis zu 60 % bei Betrachtung der komplexen Frakturen (Schatzker V und Schatzker VI) [8] oder persistierende Knieinstabilitäten mit einer Häufigkeit von 11-18% [7]. Die meisten Tibiakopffrakturen bedürfen einer operativen Therapie mit der Intention der Wiederherstellung der Gelenkfläche und der Beinachse mit der Möglichkeit der frühen aktiven und passiven Bewegungstherapie zur Vermeidung einer Gelenksteife.…”

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“…Auch nach Frakturbehandlung gewinnen die PROMs zunehmend an Bedeutung [20]. Über die Lebensqualität nach operativer Versorgung von Tibiakopffrakturen existieren nur wenige Studien [7,9,[21][22][23]. Zumeist werden aber auch hier verschiedene Frakturtypen unterschiedlichen Schweregrads gemeinsam betrachtet.…”

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Mittelfristige Ergebnisse zur Lebensqualität nach operativer Versorgung von Tibiakopffrakturen vom Typ Moore V

et al. 2016

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Dislocation fractures of the tibial plateau often lead to functional restrictions and subjective complaints from the patients. Besides functional and radiological results, criteria to determine the quality of life are of increasing importance. Intermediate term restriction in quality of life was evaluated and correlated with objective radiological results in patients with Moore type V dislocation fracture of the tibial plateau. From 2003 to 2012, a multicentre retrospective cohort study in three hospitals was used to register 36 patients with 38 Moore type V dislocation fractures of the tibial plateau. The injury mechanism, the surgical treatment (one step or two step surgery, single or double plate fixation) the complication rate, the radiological result (Kellgren/Lawrence osteoarthritis score, loss of reduction, secondary deviation of the axis) after a mean follow-up of 37 months, and the quality of life (pain and function by NRS, IKDC form, EQ 5D score) after a mean follow-up of 68 months (range, 15-128 months), were analysed. The mean age of the 27 men and the 9 women was 50.8 years. There were 30 cases of high impact injury. An external fixator was used for primary fracture stabilisation in 24 knees; definitive internal fixation was performed in a second step. Internal fixation using a single plate was used in 12 knees, and double plate fixation in 25 knees; one patient was treated definitively with an external fixator. Early complications (3 × infection, 2 × compartment syndrome, 4 × implant failure) were seen in 21.1 % of patients; all could be cured surgically. The function of the affected knee joint gave a mean NRS of 4.53; the IKDC score was 50.46, and the EQ 5D 7.47. Only two patients (5 %) were free of pain, 27 (75 %) reported mild to moderate pain, and 7 patients (20 %) reported severe pain. Four patients are retired or have applied for a pension. Altogether, the quality of life was calculated as being 44 % of the initial value before the injury. Four patients required an endoprosthetic replacement at an early stage, after an average of 6 months. Signs of osteoarthritis (Kellgren/Lawrence> I) were seen in 32 of the remaining 33 fractures; 19 of these exhibited distinct signs of osteoarthritis (Kellgren/Lawrence III, IV). Loss of reduction (≥ 2 mm) was seen in 13 (34.2 %) and deviation of axis (> 10°) in 3 patients (7.8 %). There was no relation to the surgical strategy. However, there was a correlation between the subjective assessments of the quality of life and the radiological results. Moore type V dislocation fractures of the tibial plateau are severe knee injuries resulting in a distinct reduction in quality of life in the intermediate term. There is a correlation between the subjective assessments and the objective radiological results. Therefore, the congruency of the articular surface and the axis have to be reconstructed as precisely as possible when repairing fractures of the tibial plateau.

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Mittelfristige Ergebnisse zur Lebensqualität nach operativer Versorgung von Tibiakopffrakturen vom Typ Moore V

et al. 2016

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“…Aside from the resulting reduced physical activity, the social and professional impact of these fractures is undeniable and represents significant costs for the healthcare system. A recently published prospective case series reports 28 job losses out of 41 patients treated 5…”

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Comparative evaluation of minimally invasive ‘tibial tuberoplasty’ surgical technique versus conventional open surgery for Schatzker II–III tibial plateau fractures: design of a multicentre, randomised, controlled and blinded trial (TUBERIMPACT study)

et al. 2019

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IntroductionFractures of the tibial plateau are in constant progression. They affect an elderly population suffering from a number of comorbidities, but also a young population increasingly practicing high-risk sports. The conventional open surgical technique used for tibial plateau fractures has several pitfalls: bone and skin devascularisation, increased risks of infection and functional rehabilitation difficulties. Since 2011, Poitiers University Hospital is offering to its patients a new minimally invasive technique for the reduction and stabilisation of tibial plateau fractures, named ‘tibial tuberoplasty’. This technique involves expansion of the tibial plateau through inflation using a kyphoplasty balloon, filling of the fracture cavity with cement and percutaneous screw fixation. We designed a study to evaluate the quality of fracture reduction offered by percutaneous tuberoplasty versus conventional open surgery for tibial plateau fracture and its impact on clinical outcome.Methods and analysisThis is a multicentre randomised controlled trial comparing two surgical techniques in the treatment of tibial plateau fractures. 140 patients with a Schatzker II or III tibial plateau fracture will be recruited in France. They will be randomised either in tibial tuberoplasty arm or in conventional surgery arm. The primary outcome is the postoperative radiological step-off reduction blindly measured on CT scan (within 48 hours post-op). Additional outcomes include other radiological endpoints, pain, functional abilities, quality of life assessment and health-economic endpoints. Outcomes assessment will be performed at baseline (before surgery), at day 0 (surgery), at 2, 21, 45 days, 3, 6, 12 and 24 months postsurgery.Ethics and disseminationThis study has been approved by the ethics committee Ile-De-France X and will be conducted in accordance with current Good Clinical Practice (GCP) guidelines, Declaration of Helsinki and standard operating procedures. The results will be disseminated through presentation at scientific conferences and publication in peer-reviewed journals.Trial registration numberClinicaltrial.gov:NCT03444779.

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A comparison of clinical, radiological, and quality-of-life outcomes of double-plate internal and Ilizarov external fixations for Schatzker type 5 and 6 tibia plateau fractures

Oğuzkaya

Mısır²,

Kızkapan

et al. 2021

Eur J Trauma Emerg Surg

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Lebensqualität und Arbeitsfähigkeit nach operativer Behandlung von Tibiakopffrakturen

Cited by 12 publications

References 53 publications

Mittelfristige Ergebnisse zur Lebensqualität nach operativer Versorgung von Tibiakopffrakturen vom Typ Moore V

Mittelfristige Ergebnisse zur Lebensqualität nach operativer Versorgung von Tibiakopffrakturen vom Typ Moore V

Comparative evaluation of minimally invasive ‘tibial tuberoplasty’ surgical technique versus conventional open surgery for Schatzker II–III tibial plateau fractures: design of a multicentre, randomised, controlled and blinded trial (TUBERIMPACT study)

A comparison of clinical, radiological, and quality-of-life outcomes of double-plate internal and Ilizarov external fixations for Schatzker type 5 and 6 tibia plateau fractures

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