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01-09-2017 | Original Paper

Functional outcome of intra-articular tibial plateau fractures: the impact of posterior column fractures

Authors: Juriaan van den Berg, Maike Reul, Menno Nunes Cardozo, Anastasiya Starovoyt, Eric Geusens, Stefaan Nijs, Harm Hoekstra

Published in: International Orthopaedics | Issue 9/2017

Abastract

Introduction

Although regularly ignored, there is growing evidence that posterior tibial plateau fractures affect the functional outcome. The goal of this study was to assess the incidence of posterior column fractures and its impact on functional outcome and general health status. We aimed to identify all clinical variables that influence the outcome and improve insights in the treatment strategies.

Methods

A retrospective cohort study including 218 intra-articular tibial plateau fractures was conducted. All fractures were reclassified and applied treatment was assessed according to the updated three-column concept. Relevant demographic and clinical variables were studied. The patient reported outcome was assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS).

Results

Median follow-up was 45.5 (IQR 24.9-66.2) months. Significant outcome differences between operatively and non-operatively treated patients were found for all KOOS subscales. The incidence of posterior column fractures was 61.9%. Posterior column fractures, sagittal malalignment and an increased complication rate were associated with poor outcome. Patients treated according to the updated three-column concept, showed significantly better outcome scores than those patients who were not. We could not demonstrate the advantage of posterior column fracture fixation, due to a limited patient size.

Conclusion

Our data indicates that implementation of the updated three-column classification concept may improve the surgical outcome of tibial plateau fractures. Failure to recognize posterior column fractures may lead to inappropriate utilization of treatment techniques. The current concept allows us to further substantiate the importance of reduction and fixation of posterior column fractures with restoration of the sagittal alignment.

Level of Evidence: 3

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Title: Functional outcome of intra-articular tibial plateau fractures: the impact of posterior column fractures
Authors: Juriaan van den Berg
Maike Reul
Menno Nunes Cardozo
Anastasiya Starovoyt
Eric Geusens
Stefaan Nijs
Harm Hoekstra
Publication date: 01-09-2017
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 9/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-017-3566-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Functional outcome of intra-articular tibial plateau fractures: the impact of posterior column fractures

Abastract

Introduction

Methods

Results

Conclusion

Level of Evidence: 3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abastract

Introduction

Methods

Results

Conclusion

Level of Evidence: 3

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