Functional and Clinical Outcomes of Nonsurgically Managed Tibial Plateau Fractures. Issue 5 (May 2017)

• Record Type: Journal Article
• Authors: Pean, Christian A.; Driesman, Adam; Christiano, Anthony; Konda, Sanjit R.; Davidovitch, Roy; Egol, Kenneth A.
• Is Part Of: Journal of the American Academy of Orthopaedic Surgeons. Volume 25:Issue 5(2017)
• Publication Date: 2017-05
• Subjects: tibial plateau -- fractures -- nonsurgical management -- outcomes -- comorbidities; Orthopedics -- Periodicals; Orthopedic surgery -- Periodicals; Joint Diseases -- Periodicals; Orthopedics -- Periodicals; Orthopedic surgery; Orthopedics; Periodicals; 616.7005
• DOI: 10.5435/JAAOS-D-16-00217
• Languages: English
• ISSNs: 1067-151X

Abstract

Abstract : Introduction: This study sought to assess and compare long-term functional and clinical outcomes in patients with tibial plateau fractures that are treated nonsurgically. Methods: Over a period of 8 years, 305 consecutive tibial plateau fractures were treated by three surgeons at a single institution and followed prospectively in an Institutional Review Board–approved study. Overall, 41 patients (13%) were treated nonsurgically and 37 were available for follow-up. Indications for nonsurgical management were minimal fracture displacement or preclusion of surgery because of comorbidities. A series of univariate retrospective analyses were used to identify individual risk factors potentially predictive of Short Musculoskeletal Functional Assessment scores. Results: Thirty-seven patients were included with a mean follow-up of 21 ± 14.9 months. Overall, 59% of patients (n = 22) attained good to excellent functional outcomes. In patients for whom surgery was precluded because of comorbidities, outcome scores were significantly poorer (38.8 ± 23.0 versus 12.7 ± 14.2; P = 0.001). Surgery precluded by a factor other than minimal fracture displacement predicted poor outcome ( P = 0.002). Discussion: Carefully selected patients with minimally displaced tibial plateau fractures can expect good to excellent outcomes when treated nonsurgically. Level of Evidence: Level III, retrospective comparative study