J Knee Surg 2020; 33(04): 394-398
DOI: 10.1055/s-0039-1677822
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Medium-Term Results after Surgical Treatment of High-Energy Tibial Plateau Fractures

Dimitrios Evangelopoulos
1   5th Department of Orthopaedic, Geniko Nosokomeio Attikes KAT, Athens, Attike, Greece
,
Stavros Chalikias
1   5th Department of Orthopaedic, Geniko Nosokomeio Attikes KAT, Athens, Attike, Greece
,
Mihail Michalos
1   5th Department of Orthopaedic, Geniko Nosokomeio Attikes KAT, Athens, Attike, Greece
,
Dimitrios Vasilakos
1   5th Department of Orthopaedic, Geniko Nosokomeio Attikes KAT, Athens, Attike, Greece
,
1   5th Department of Orthopaedic, Geniko Nosokomeio Attikes KAT, Athens, Attike, Greece
,
Konstantinos Zisis
1   5th Department of Orthopaedic, Geniko Nosokomeio Attikes KAT, Athens, Attike, Greece
,
George Koundis
1   5th Department of Orthopaedic, Geniko Nosokomeio Attikes KAT, Athens, Attike, Greece
,
Constantine Kokoroghiannis
1   5th Department of Orthopaedic, Geniko Nosokomeio Attikes KAT, Athens, Attike, Greece
› Author Affiliations
Further Information

Publication History

25 July 2018

16 December 2018

Publication Date:
06 February 2019 (online)

Abstract

The aim of the article is to present the medium-term results of surgical treatment of Schatzker's IV, V, and VI tibial plateau fractures, in a retrospective study of 22 patients at a level-1 trauma center. Twenty-two of 34 patients with Schatzker's IV–VI fractures completed follow-up at a mean of 56 months (range: 7–103 months). Patients' mean age was 47.6 years (range: 18–76 years). Open reduction and internal fixation were performed in 16 patients, while external fixators were used in the remaining six patents. Patients were assessed radiologically for the presence of arthritis using the Kellgren–Lawrence scale. Functional outcomes were measured using the Lysholm's knee score, knee injury, and osteoarthritis outcome score (KOOS). Quality of life was also assessed postoperatively using the EuroQol-5D (EQ-5D) form and EQ-VAS (visual analogue scale) score. There were no postoperative infections and no fracture went on to nonunion. Absence of arthritic change was noted in only 6.3% of cases. The average KOOS score was 80 and the average Lysholm's score was 84.91. Regarding the postoperative quality of life, mobility was impaired in 45.5%, self-care in 27.3%, and usual activities in 36.3% of patients. Pain or discomfort was reported in 77.2% and anxiety or depression in 40.9% of cases. The mean VAS score was 77.8. Eighty percent of patients had returned to their previous activities at the time of last follow-up. Although complex tibial plateau fractures are associated with a high rate of complications and can have a severe impact on the injured knee, most patients had quite satisfactory results during their medium-term clinical evaluation, in our study. It is a Level IV case series study.

 
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