Skip to main content
SpringerLink
Log in

The outcome after lateral tibial plateau fracture treated with percutaneus screw fixation show a tendency towards worse functional outcome compared with a reference population

  • Original Article
  • Published:
European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

The objective of this study was to evaluate the functional and radiological outcome after lateral tibial plateau fractures (Müller AO classification (AO) 41-B1, B2 and B3) treated with minimal invasive bone tamp reduction and percutaneous screw fixation.

Methods

Retrospective, cross-sectional study. Review and clinical examination of 37 patients treated between 2005 and 2010. The patients completed a clinical examination, Knee Injury and Osteoarthritis Outcome Score (KOOS) and questionnaire evaluating QOL (Eq5D-5L).

Results

Thirty-seven patients agreed to participate (76 %). Mean time of follow-up was 5.2 years. At final follow-up, maintained anatomical joint reduction was achieved in 34 patients. The mean KOOS score was pain = 84.4, ADL = 88.4, symptoms = 80.7, QOL = 70.3, sport = 59.6. Compared with the established KOOS reference population patients, the current study reports a tendency towards worse KOOS scores but is only significant for KOOS sport. The mean Eq5D-5L index was 0.815 and shows a tendency towards worse outcome compared with the reference population. Mean knee flexion: 125.7° (95–135). A reduced number of sit-to-stands in the mean 30-s chair stand test showed a significant negative association with KOOS. The study showed a significant association between younger age at surgery and worse KOOS outcome.

Conclusion

At 5.2-year follow-up, the patients reported a tendency towards worse KOOS and Eq5D-5L scores compared with established reference populations. This study shows a significant association between a decrease in muscle strength and worse KOOS outcome. Furthermore, a significant association between younger age at the time of surgery and worse KOOS outcome score was observed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Jansen H, Frey SP, Doht S, et al. Medium-term results after complex intra-articular fractures of the tibial plateau. J Orthop Sci. 2013;18:569–77.

    Article  PubMed  Google Scholar 

  2. Sament R, Mayanger JC, Tripathy SK, Sen RK, et al. Closed reduction and percutaneous screw fixation for tibial plateau fractures. J Orthop Surg (Hong Kong). 2012;20:37–41.

    Google Scholar 

  3. Manidakis N, Dosani A, Dimitriou R, et al. Tibial plateau fractures: functional outcome and incidence of osteoarthritis in 125 cases. Int Orthop. 2010;34:565–70.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Blokker CP, Rorabeck CH, Bourne RB. Tibial plateau fractures. An analysis of the results of treatment in 60 patients. Clin Orthop Relat Res. 1984;182:193–9.

    PubMed  Google Scholar 

  5. Ebraheim NA, Sabry FF, Haman SP. Open reduction and internal fixation of 117 tibial plateau fractures. Orthopedics. 2004;27:1281–7.

    PubMed  Google Scholar 

  6. Lee JA, Papadakis SA, Moon C, Zalavras CG. Tibial plateau fractures treated with the less invasive stabilisation system. Int Orthop. 2007;31:415–8.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Ali AM, Burton M, Hashmi M, Saleh M. Outcome of complex fractures of the tibial plateau treated with a beam-loading ring fixation system. J Bone Joint Surg Br. 2003;85:691–9.

    PubMed  Google Scholar 

  8. Ramos T, Ekholm C, Eriksson BI et al., The Ilizarov external fixator—a useful alternative for the treatment of proximal tibial fractures. A prospective observational study of 30 consecutive patients. BMC Musculoskelet Disord. 2013; 14:11. doi:10.1186/1471-2474-14-30.

  9. Koval KJ, Sanders R, Borrelli J, et al. Indirect reduction and percutaneous screw fixation of displaced tibial plateau fractures. J Orthop Trauma. 1992;6:340–6.

    Article  CAS  PubMed  Google Scholar 

  10. Houben PF, van der Linden ES, van den Wildenberg FA, Stapert JW. Functional and radiological outcome after intra-articular tibial plateau fractures. Injury. 1997;28:459–62.

    Article  CAS  PubMed  Google Scholar 

  11. Berkes MB, Little MT, Schottel PC, et al. Outcomes of Schatzker II tibial plateau fracture open reduction internal fixation using structural bone grafts. J Orthop Trauma. 2013;28:97–102.

    Article  Google Scholar 

  12. Marsh JL, Slongo TF, Agel J, et al. Fracture and dislocation classification compendium—2007: Orthopaedic Trauma Association Classification, Database and Outcome Committee. J Orthop Trauma. 2007;21:1–133.

    Article  Google Scholar 

  13. KOOS questionnaire [KOOS web site]. http://www.koos.nu. Accessed 12 June 2011.

  14. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16:494–502.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Rasmussen PS. Tibial condylar fractures. Impairment of knee joint stability as an indication for surgical treatment. J Bone Joint Surg Am. 1973;55:1331–50.

    CAS  PubMed  Google Scholar 

  16. Perruccio AV, Stefan Lohmander L, Canizares M, et al. The development of a short measure of physical function for knee OA KOOS-physical function shortform (KOOS-PS)—an OARSI/OMERACT initiative. Osteoarthr Cartil. 2008;16:542–50.

    Article  CAS  PubMed  Google Scholar 

  17. Roos EM, Roos HP, Lohmander LS, et al. Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther. 1998;28:88–96.

    Article  CAS  PubMed  Google Scholar 

  18. Roos EM, Roos HP, Ekdahl C, Lohmander LS. Knee Injury and Osteoarthritis Outcome Score (KOOS)—validation of a Swedish version. Scand J Med Sci Sports. 1998;8:439–48.

    Article  CAS  PubMed  Google Scholar 

  19. Roos EM, Lohmander LS. The Knee Injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes. 2003;1:64.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Paradowski PT, Bergman S, Sunden-Lundius A, et al. Knee complaints vary with age and gender in the adult population. Population-based reference data for the Knee Injury and Osteoarthritis Outcome Score (KOOS). BMC Musculoskelet Disord. 2006;7:38.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Eq-5d questionnare. http://www.euroqol.org/about-eq-5d/publications/user-guide.html (2012). Accessed 15 June 2012.

  22. Rikli RE, Jones CJ. Development and validity of functional fitness test for community-residing older adults. J Aging Phys Act. 1999;7:127–59.

    Google Scholar 

  23. Parmar V, Shyam Kumar AJ, Harper WM. Reliability of the GAITRite walkway system for the quantification of temporo-spatial parameters of gait in young and older people. Gait Posture. 2006;23:523 (author reply 524–5).

    Article  PubMed  Google Scholar 

  24. Kuys SS, Brauer SG, Ada L. Test-retest reliability of the GAITRite system in people with stroke undergoing rehabilitation. Disabil Rehabil. 2011;33:1848–53.

    Article  PubMed  Google Scholar 

  25. McDonough AL, Batavia M, Chen FC, et al. The validity and reliability of the GAITRite system’s measurements: a preliminary evaluation. Arch Phys Med Rehabil. 2001;82:419–25.

    Article  CAS  PubMed  Google Scholar 

  26. Sorensen J, Davidsen M, Gudex C, et al. Danish EQ-5D population norms. Scand J Public Health. 2009;37:467–74.

    Article  PubMed  Google Scholar 

  27. Honkonen SE. Degenerative arthritis after tibial plateau fractures. J Orthop Trauma. 1995;9:273–7.

    Article  CAS  PubMed  Google Scholar 

  28. DeCoster TA, Nepola JV, el-Khoury GY. Cast brace treatment of proximal tibia fractures. A ten-year follow-up study. Clin Orthop Relat Res. 1988;231:196–204.

    PubMed  Google Scholar 

  29. Jensen DB, Rude C, Duus B, Bjerg-Nielsen A. Tibial plateau fractures. A comparison of conservative and surgical treatment. J Bone Joint Surg Br. 1990;72:49–52.

    CAS  PubMed  Google Scholar 

  30. Rademakers MV, Kerkhoffs GM, Sierevelt IN, et al. Operative treatment of 109 tibial plateau fractures: five- to 27-year follow-up results. J Orthop Trauma. 2007;21:5–10.

    Article  CAS  PubMed  Google Scholar 

  31. Goff T, Kanakaris NK, Giannoudis PV. Use of bone graft substitutes in the management of tibial plateau fractures. Injury. 2013;44(Suppl 1):S86–94.

    Article  PubMed  Google Scholar 

  32. Ong JC, Kennedy MT, Mitra A, Harty JA. Fixation of tibial plateau fractures with synthetic bone graft versus natural bone graft: a comparison study. Ir J Med Sci. 2012;181:247–52.

    Article  CAS  PubMed  Google Scholar 

  33. Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport. 1999;70:113–9.

    Article  CAS  PubMed  Google Scholar 

  34. Larsen P, Lund H, Laesoe U, et al. Restrictions in quality of life after intramedullary nailing of tibial shaft fracture. A retrospective follow-up study of 223 cases. J Orthop Trauma. 2013; accepted 18-10-13.

Download references

Acknowledgments

The Department of Orthopaedic surgery and the Department of Occupational and Physiotherapy Aalborg University Hospital, Denmark, were acknowledged for approving unrestricted grants. The authors did not receive benefits or grants in any form from a commercial part related directly or indirectly to the subject of this article.

Conflict of interest

Rasmus Elsoe, Peter Larsen, Nitesh Shekhrajka, Luis Ferreira, Svend Erik Ostgaard, Sten Rasmussen declare that they have no conflict of interest.

Ethical standard

This study was conducted in accordance with the ethical standards of the responsible committee and with the ethical principles of the 1975 Declaration of Helsinki. The study was approved by the Danish Data Protection Agency (J. No. 2010-41-4354). All participants gave their informed consent prior to their inclusion in the study.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg University, 18-22 Hobrovej, 9000, Aalborg, Denmark

    R. Elsoe, L. Ferreira, S. E. Ostgaard & S. Rasmussen

  2. Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark

    P. Larsen

  3. Department of Radiology, Aalborg University Hospital, Aalborg, Denmark

    N. Shekhrajka

  4. Orthopaedic Surgery Research Unit, Research and Innovation Center, Aalborg University Hospital, Aalborg, Denmark

    S. Rasmussen

  5. Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

    S. E. Ostgaard & S. Rasmussen

  6. Department of Clinical Medicine, Aarhus University, Aarhus, Denmark

    S. Rasmussen

Authors
  1. R. Elsoe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Larsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. N. Shekhrajka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. L. Ferreira
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S. E. Ostgaard
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. Rasmussen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. Elsoe.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Elsoe, R., Larsen, P., Shekhrajka, N. et al. The outcome after lateral tibial plateau fracture treated with percutaneus screw fixation show a tendency towards worse functional outcome compared with a reference population. Eur J Trauma Emerg Surg 42, 177–184 (2016). https://doi.org/10.1007/s00068-015-0497-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00068-015-0497-9

Keywords

Search

Navigation