PMID- 31362547
OWN - NLM
STAT- MEDLINE
DCOM- 20190812
LR  - 20190812
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 101-B
IP  - 8
DP  - 2019 Aug
TI  - Mapping recovery in simple and complex tibial plateau fracture fixation.
PG  - 1009-1014
LID - 10.1302/0301-620X.101B8.BJJ-2018-1288.R1 [doi]
AB  - AIMS: The aim of this study was to determine the trajectory of recovery following 
      fixation of tibial plateau fractures up to five-year follow-up, including simple 
      (Schatzker I-IV) versus complex (Schatzker V-VI) fractures. PATIENTS AND METHODS: 
      Patients undergoing open reduction and internal fixation (ORIF) for tibial 
      plateau fractures were enrolled into a prospective database. Functional outcome, 
      using the 36-Item Short Form Health Survey Physical Component Summary (SF-36 
      PCS), was collected at baseline, six months, one year, and five years. The 
      trajectory of recovery for complex fractures (Schatzker V and VI) was compared 
      with simple fractures (Schatzker I to IV). Minimal clinically important 
      difference (MCID) was calculated between timepoints. In all, 182 patients were 
      enrolled: 136 (74.7%) in simple and 46 (25.3%) in complex. There were 103 female 
      patients and 79 male patients with a mean age of 45.8 years (15 to 86). RESULTS: 
      Mean SF-36 PCS improved significantly in both groups from six to 12 months (p < 
      0.001) and one to five years (simple, p = 0.008; complex, p = 0.007). In both 
      groups, the baseline scores were not reached at five years. The SF-36 PCS was 
      significantly higher in the simple group compared with the complex group at both 
      six months (p = 0.007) and 12 months (p = 0.01), but not at five years (p = 
      0.17). Between each timepoint, approximately 50% or more of the patients in each 
      group achieved an MCID in their score change, indicating a significant clinical 
      change in condition. The complex group had a much larger drop off in the first 
      six months, with comparable proportions achieving MCID at the subsequent time 
      intervals. CONCLUSION: Tibial plateau fracture recovery was characterized overall 
      by an initial decline in functional outcome from baseline, followed by a steep 
      improvement from six to 12 months, and ongoing recovery up to five years. In 
      simple patterns, patients tended to achieve a higher functional score by six 
      months compared with the complex patterns. However, comparable functional scores 
      between the groups achieved only at the five-year point suggest later recovery in 
      the complex group. Function does not improve to baseline by five years in either 
      group. This information is useful in counselling patients about the course of 
      prospective recovery. Cite this article: Bone Joint J 2019;101-B:1009-1014.
FAU - Ramoutar, D N
AU  - Ramoutar DN
AD  - Department of Orthopaedics, University Hospitals Coventry and Warwickshire, 
      Coventry, UK.
FAU - Lefaivre, K
AU  - Lefaivre K
AD  - Department of Orthopaedics, Division of Orthopaedic Trauma, University of British 
      Columbia, Vancouver General Hospital, Vancouver, Canada.
FAU - Broekhuyse, H
AU  - Broekhuyse H
AD  - Department of Orthopaedics, Division of Orthopaedic Trauma, University of British 
      Columbia, Vancouver General Hospital, Vancouver, Canada.
FAU - Guy, P
AU  - Guy P
AD  - Department of Orthopaedics, Division of Orthopaedic Trauma, University of British 
      Columbia, Vancouver General Hospital, Vancouver, Canada.
FAU - O'Brien, P
AU  - O'Brien P
AD  - Department of Orthopaedics, Division of Orthopaedic Trauma, University of British 
      Columbia, Vancouver General Hospital, Vancouver, Canada.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Follow-Up Studies
MH  - *Fracture Fixation, Internal
MH  - *Fracture Healing
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Open Fracture Reduction
MH  - Prospective Studies
MH  - *Recovery of Function
MH  - Tibial Fractures/*surgery
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - Functional outcome
OT  - Knee
OT  - SF-36
OT  - Tibial plateau
EDAT- 2019/08/01 06:00
MHDA- 2019/08/14 06:00
CRDT- 2019/08/01 06:00
PHST- 2019/08/01 06:00 [entrez]
PHST- 2019/08/01 06:00 [pubmed]
PHST- 2019/08/14 06:00 [medline]
AID - 10.1302/0301-620X.101B8.BJJ-2018-1288.R1 [doi]
PST - ppublish
SO  - Bone Joint J. 2019 Aug;101-B(8):1009-1014. doi: 
      10.1302/0301-620X.101B8.BJJ-2018-1288.R1.