Abstract
The purpose of this study is to determine when functional outcome no longer improves
following tibial plateau fracture. A patient series of operatively treated tibial
plateau fractures was reviewed. Patients were evaluated using the short musculoskeletal
function assessment (SMFA), range of motion (ROM) assessment, and pain levels at visual
analog scale (VAS) at 3, 6, and 12 months postoperatively. Fractures were classified
by the Schatzker's classification using preoperative imaging. The case series was
divided into two groups based on fracture patterns. Friedman's tests were conducted
to determine if there were differences in SMFA, ROM, or VAS throughout the postoperative
course. A total of 117 patients with tibial plateau fractures treated operatively,
with complete follow-up and without complication, were identified. Seventy-seven patients
(65.8%) sustained lateral tibial plateau fractures (Schatzker's I–III). Friedman's
test demonstrated significant differences in SMFA (p < 0.0005) and ROM (p < 0.0005) at the three time points. Post hoc analysis demonstrated a significant
difference in SMFA (p < 0.0005) and ROM (p = 0.003) between 3 and 6 months postoperatively but no significant difference in
either metric between 6 and 12 months postoperatively. Friedman's test demonstrated
no significant difference in VAS postoperatively (p = 0.210). Forty patients (34.2%) sustained medial or bicondylar tibial plateau fractures
(Schatzker's IV–VI). Friedman's test demonstrated significant differences in SMFA
(p < 0.0005) and ROM (p < 0.0005) at the three time points. Post hoc analysis demonstrated a strong trend
toward significance in SMFA between 3 and 6 months postoperatively (p = 0.088), and demonstrated a significant difference between 6 and 12 months postoperatively
(p = 0.013). ROM was found to be significantly different between 3 and 6 months postoperatively
(p = 0.010), but no difference was found between 6 and 12 months postoperatively (p = 0.929). Friedman's test demonstrated no significant difference in VAS postoperatively
(p = 0.941). In this cohort, no significant difference in function, ROM, or pain level
exists between 6 and 12 months after treatment of lateral tibial plateau fractures.
However, there are significant improvements in function for at least 1 year following
medial or bicondylar tibial plateau fractures.
Keywords
tibial plateau - orthopaedic trauma - knee fracture - tibial plateau outcomes
