• Matthias Krause, Lena Alm, Markus Berninger, Christoph Domnick, Kai Fehske, Karl-Heinz Frosch, Elmar Herbst, Alexander Korthaus, Michael Raschke, Reinhard Hoffmann, and “Fracture committee” of the German Knee Society.
• Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martini Str. 52, 20246, Hamburg, Germany. m.krause@uke.de.
• Eur J Trauma Emerg Surg. 2020 Dec 1; 46 (6): 1227-1237.

PurposeGiven that tibial plateau fractures (TPF) are rare, they may pose a challenge to the treating surgeon due to their variety of complex fracture patterns. Numerous studies have identified potential fracture-specific, surgery-related, and patient-related risk factors for impaired patient outcomes. However, reports on the influence of bone metabolism on functional outcomes are missing.MethodsIn a retrospective multicenter cohort study, 122 TPF of 121 patients were analyzed with respect to radiological and clinical outcomes (Rasmussen) with a mean follow-up of 35.7 ± 24.9 months. The risk factor assessment included bone metabolism-affecting comorbidities and medication.ResultsThe findings showed that 95.9% of the patients reported a good-to-excellent clinical outcome, and 97.4% reported a good-to-excellent radiological outcome. Logistic regression revealed that potentially impaired bone metabolism (IBM) was an independent risk factor for the clinical (p = 0.016) but not the radiological outcome (Table 4). Patients with 41-type B fractures and a potential IBM had a seven times higher risk to present a fair-to-poor clinical outcome [OR 7.45, 95 CI (4.30, 12.92)]. The most common objective impairment was a limited range of motion in 16.4% of the patients, especially in 41-type C fractures (p = 0.06). The individual failure analysis additionally identified surgery-related options for improvement.ConclusionThis study demonstrated that potential IBM was an independent risk factor for a poor-to-fair clinical outcome.

26 keywords...

hide…