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J Knee Surg 2018; 31(07): 670-676
DOI: 10.1055/s-0037-1606561
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Postoperative Computed Tomography Evaluation of Posterior Tibial Plateau Fractures: Mean 7-Year Clinical Follow-Up

Dongzhe Li
1   Department of Orthopaedics, Sichuan University, West China Hospital, Chengdu, China
,
Yue Fang
1   Department of Orthopaedics, Sichuan University, West China Hospital, Chengdu, China
,
Yu Liang
1   Department of Orthopaedics, Sichuan University, West China Hospital, Chengdu, China
,
Kunlong Ma
1   Department of Orthopaedics, Sichuan University, West China Hospital, Chengdu, China
,
Chang Zou
1   Department of Orthopaedics, Sichuan University, West China Hospital, Chengdu, China
› Author Affiliations
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Publication History

24 July 2016

04 August 2017

Publication Date:
14 September 2017 (online)

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Abstract

The aim is to assess the association between computed tomography (CT) findings and clinical outcomes in posterior tibial plateau fractures (TPF). This is a retrospective analysis of the records of 23 patients with posterior TPF treated at our institution between 2004 and 2011. Two indices of residual articular displacement of posterior TPF (gap and step-off) were measured from CT images, and clinical outcomes were assessed using the Short Musculoskeletal Function Assessment (SMFA) questionnaire. Spearman's rank correlation coefficient analysis was used to evaluate the correlations between the postoperative posterior TPF radiological findings and the clinical outcomes. Both the intraobserver and the interobserver correlation coefficients were high (0.90 and 0.92, respectively), indicating excellent agreement between the reviewers for the assessment of residual displacement via CT scans. Additionally, residual articular step displacement showed a strongly negative correlation with clinical outcomes (R = 0.700, p = 0.036), whereas the residual gap displacement did not (R = 0.400, p = 0.505). More importantly, the medial posterior step displacement was significantly correlated with the clinical outcomes (p = 0.040), whereas the lateral posterior step displacement was not (p = 0.618). Based on the data of this study, the higher the step-off deformity of the medial posterior tibial plateau, the worse the SMFA. More attention should be paid to this factor when treating medial posterior TPF.

Keywords

tibial plateau fracture - clinical outcomes - computed tomography

Note

Our study was approved by the Clinical Trials and Ethics Committee of the hospital and was conducted in accordance with the Declaration of Helsinki, and informed consent was obtained from the patients or their relatives.


 

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