Outcome und Komplikationen nach proximalen Tibiafrakturen

Kraus, Tobias M.; Freude, Thomas; Stöckle, Ulrich; Stuby, Fabian

doi:10.1007/s00132-015-3206-9

Cited by 15 publications

(7 citation statements)

References 31 publications

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“…In contrast to return-to-work, patients with previous knee surgery showed significantly lower expectations regarding return-to-sports. In comparison to the expectations formulated in this study, other studies showed, that return-to-sports was possible, but on a less demanding level [19,20]. Loibl et al showed that only around 50% of skiers returned to skiing after proximal tibial fracture [21].…”

Section: Patients Overestimate Their Prognosis Regarding Return-to-spcontrasting

confidence: 52%

Patients with complex proximal tibial fractures overestimate the prognosis of their injury

Keppler

Ihle³

et al. 2021

Eur J Trauma Emerg Surg

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Purpose To investigate, if patients with complex proximal tibial fracture have realistic expectations on open reduction and internal fixation. Methods 114 patients (mean 49 years, SD ± 13) with closed AO-type B and C proximal tibial fracture were grouped (group B, respectively C). Prior to surgery expectations concerning knee function, pain, return to work/sports, and the risk for osteoarthritis was assessed with the Hospital for Special Surgery-Knee Surgery Expectations Survey (HFSS-KSE) and a non-validated ten-item survey. Results 92% of patients expected at least an almost natural knee postoperatively. All items regarding restoring knee function were ranked to be at least important in both groups. 65% in group B and 47% in group C expected at most occasional pain. 83% in group B and 67% in group C expected full return to work without any limitations. Patients with low physical work intensity expected significantly shorter incapacity to work in both groups (7.8, respectively 8.9 weeks). 71% in group B and 60% in group C expected to return to sports with at most small limitations. 33% in group B and 22% in group C assumed risk for osteoarthritis will be prevented by surgery. Conclusion Expectations on surgery for complex proximal tibial fracture are high regardless of fracture type. The prognosis of many health and lifestyle domains was overestimated. The risk for osteoarthritis was underestimated. This study should sensitize surgeons to discuss realistic expectations. This may help to improve patient comprehension what leads to sensible expectations, resulting in improved patients´ satisfaction. Level of evidence IV. Trial registration number 14104, Date of registration: 06/2015.

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Section: Patients Overestimate Their Prognosis Regarding Return-to-spcontrasting

confidence: 52%

Patients with complex proximal tibial fractures overestimate the prognosis of their injury

Keppler

Ihle³

et al. 2021

Eur J Trauma Emerg Surg

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“…The treatment of tibial plateau fractures in this study group was performed according to the AO principles [ 15 – 17 ]. CT scans are in most cases essential; in case of temporary external fixation, the CT scan is recommended to be performed after the external stabilization because with stretching of the fixateur an initial reposition is achievable [ 3 ]. Due to better visualization and understanding of the fractures themselves postero-lateral or postero-medial fragments were addressed as key fragments [ 16 – 18 ] (Figs.…”

Section: Methodsmentioning

confidence: 99%

“…Since the clinical outcome after tibial plateau fractures is closely related to the quality of the reduction [ 1 , 2 ], each surgical technique must aim for an anatomic reconstruction of the injured joint. However, despite sophisticated understanding of the fracture patterns and modern anatomic angular stable implants the precise reconstruction of displaced or comminuted tibial plateau fractures can be challenging even for experienced trauma surgeons [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Duration of incapacity of work after tibial plateau fracture is affected by work intensity

Kraus

Abele

Freude

et al. 2018

BMC Musculoskelet Disord

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BackgroundTibial plateau fractures requiring surgery are severe injuries of the lower extremity. Tibial plateau fractures have an impact not only on physically demanding jobs but notably on general professional life too. The aim of this study was to assess how the professional activity of patients will be affected after a tibial plateau fracture.Methods39 consecutive patients (ages 20–61 years) were retrospectively included in the study and were clinically examined at a minimum of 14 month postoperatively. Inclusion criteria were surgical treatment of tibial plateau fractures between November 2009 and December 2012. The clinical evaluation included the Lysholm score and the Oxford Knee Score. Fractures were classified and analyzed using the AO classification. Intensity of work was classified as established by the REFA Association. The patients themselves provided postoperative duration of the incapacity of work and subjective ratings.Results17 (43.6%) women and 22 (56.4%) men were examined with a mean follow-up of 29.7 ± 10.4 months (range 14–47). According to the AO classification there were 20 (51.3%) B-type-fractures and 19 (48.7%) C-type-fractures. The median incapacity of work was 120 days (range 10–700 days) with no significant differences between B- and C-type-fractures. Four (10.3%) patients reduced their working hours by 10.5 h per week on average. Patients with low workload (REFA 0–1, median incapacity of work 90 days, range 10–390 days) had a significant shorter incapacity of work than patients with heavy workload (REFA 2–4, median incapacity of work 180 days, range 90–700 days) (p < 0.05). The median Lysholm score decreased significantly from 100 points (range 69–100) before the injury to 73 points (range 23–100) at the time of the follow-up. All patients received postoperative physiotherapy (median 25 appointments, range 6–330), with a significant higher number of appointments for C-type-fractures than for B-type-fractures (p = 0.004).ConclusionA relationship was found between workload and the duration of incapacity of work after tibial plateau fractures. The post-injury shift to less demanding jobs and the reduction of working hours highlight the impact of a tibial plateau fracture on a patient’s subsequent physical ability to work.

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“…Consequently, the treatment strategies for this complex injury have undergone changes. Nowadays, computer tomography (CT) imaging is considered the gold standard for diagnostics [2], leading to the development of novel classification systems [3] and the establishment of a 360 • operative treatment [4,5].…”

Section: Introductionmentioning

confidence: 99%

Mismatch between Clinical–Functional and Radiological Outcome in Tibial Plateau Fractures: A Retrospective Study

Bormann,

Bitschi,

Neidlein

et al. 2023

JCM

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Background: The evaluation of tibial plateau fractures (TPF) encompasses the assessment of clinical–functional and radiological parameters. In this study, the authors aimed to investigate the potential correlation between these parameters by utilizing both the clinical–functional and the modified radiological Rasmussen score. Methods: In this retrospective monocentric study conducted at a level-I trauma center, patients who underwent surgery between January 2014 and December 2019 due to a TPF were included. The clinical–functional Rasmussen score prior to the injury, at 1-year postoperatively, and during the last follow-up (minimum 18 months) was assessed using a standardized questionnaire. Additionally, the modified radiological Rasmussen score was determined at the 1-year postoperative mark using conventional radiographs in two planes. Results: A total of 50 patients were included in this study, comprising 40% (n = 20) men, and 60% (n = 30) women, with an average age of 47 ± 11.8 years (range 26–73 years old). Among them, 52% (n = 26) had simple fractures (classified according to Schatzker I–III), while 48% (n = 24; according to Schatzker IV–VI) had complex fractures. The mean follow-up was 3.9 ± 1.6 years (range 1.6–7.5 years). The functional Rasmussen score assessed before the injury and at follow-up showed an “excellent” average result. However, there was a significant difference in the values of complex fractures compared to before the injury. One year postoperatively, both the clinical–functional score and the modified radiological score demonstrated a “good” average result. The “excellent” category was more frequently observed in the functional score, while the “fair” category was more common in the radiological score. There was no agreement between the categories in both scores in 66% of the cases. Conclusions: The data from this retrospective study demonstrated that patients with TPF are able to achieve a nearly equivalent functional level in the medium-term after a prolonged recovery period, comparable to their pre-injury state. However, it is important to note that the correlation between clinical–functional and radiological parameters is limited. Consequently, in order to create prospective outcome scores, it becomes crucial to objectively assess the multifaceted nature of TPF injuries in more detail, both clinically and radiologically.

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Outcome und Komplikationen nach proximalen Tibiafrakturen

Cited by 15 publications

References 31 publications

Patients with complex proximal tibial fractures overestimate the prognosis of their injury

Patients with complex proximal tibial fractures overestimate the prognosis of their injury

Duration of incapacity of work after tibial plateau fracture is affected by work intensity

Mismatch between Clinical–Functional and Radiological Outcome in Tibial Plateau Fractures: A Retrospective Study

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