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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 1/2021

01-02-2021 | Tibial Plateau Fracture | Original Article

Poor sporting abilities after tibial plateau fractures involving the posterior column: how can we do better?

Authors: Liselore Quintens, Juriaan Van den Berg, Maike Reul, Esther Van Lieshout, Stefaan Nijs, Michiel Verhofstad, Harm Hoekstra

Published in: European Journal of Trauma and Emergency Surgery | Issue 1/2021

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Abstract

Purpose

Tibial plateau fractures with the involvement of the posterior column are an important prognostic factor towards poor functional outcome. We aimed to assess the sporting abilities postoperatively with special emphasis on the type of sports and sport-specific movements, as well as time needed to resume sports, restricting factors in sports engagement, and patient satisfaction. We aimed to provide prognostic information on return to sports.

Methods

Demographic, clinical and radiological variables were retrospectively collected from 82 multicentric patients between 2014 and 2016. Prospectively, sporting abilities before and after surgery were determined using questionnaires at a mean follow-up of 33 months postoperatively.

Results

Involvement in sports significantly decreased, with only 68.4% of patients resuming sports (p < 0.001). The mean time needed to partially or fully resume sports was 6–9 and 9–12 months, respectively. The ability to resume at the pre-injury level of effort and performance was 22% and 12%, respectively. Restricting factors were pain (66%), fear of re-injury (37%), limited range of motion (26%), and instability (21%). The majority (59%) of patients were unsatisfied with their physical abilities. Significantly worse outcomes were observed in patients playing high-impact sports, experiencing knee pain during physical activity, suffering from extension/valgus or flexion/varus trauma.

Conclusions

Tibial plateau fractures with the involvement of the posterior column significantly hamper the patients’ sporting abilities, leaving the majority of patients unsatisfied. Preoperative counseling about prognosis, setting realistic expectations, optimizing rehabilitation and pain management postoperatively, and advising low-impact sports might improve engagement in physical activities and emotional impact on patients.

Level of evidence

3.
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Metadata
Title
Poor sporting abilities after tibial plateau fractures involving the posterior column: how can we do better?
Authors
Liselore Quintens
Juriaan Van den Berg
Maike Reul
Esther Van Lieshout
Stefaan Nijs
Michiel Verhofstad
Harm Hoekstra
Publication date
01-02-2021
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 1/2021
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-019-01220-3

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