Functional results and complications of tibial plateau due to high-energy trauma.
Abstract
Introduction Tibial Plateau Fractures represent 1% of all fractures. The type of treatment for these fractures continues being controversial. The functional result mainly depends on the knee´s range of motion, stability of the joint and the pain suffered by the patient. Only a few cases evaluate the functional result of the knee after a secondary tibial plateau fracture to high energy fractures. Materials and Methods Number of cases, 51 patients, 34 males and 17 females, average age of 48, follow- up average of 42 months. Range of movement (ROM) was assessed; functional results were evaluated with the KOOS test. Pain was evaluated using the VAS scale and the diagnosis of complications was performed through anamnesis, physical examination and complementary methods.Results 51 patients, 69% due to motorbike accidents and 6% car accidents; 23% falls from heights and 2% from sport activity. 33 left knees and 18 right knees. 25 patients suffered Schatzker type V fractures (two of them were Gustilo exposed fractures, grades IIIa and IIIc) and 26 were type VI (one Gustilo IIIc). Among the Schatzker type V fractures, the average ROM was 2,4°-120,68°, in Schatzker VI fractures, average 1,5°-118,04°. Regarding pain, considering the VAS scale, Shatzker V and VI classifications showed significant differences (p=0,0403), since in the first one, 50 % of the patients reported no pain, and only 25% reported a VAS pain score higher or equal to 2. In patients with Schatzker VI fractures, the pattern was different since 50% indicated pain score over 2 and 25% higher than 3. 22% of the patients showed complications.Discussion Tibial Plateau Fractures remain being a pathology in which the results can considerably modify life quality in patients. Therefore, patients must be informed about the possible bad functional outcomes in the long run, require multiple surgeries, as well as the possibility of being unable to regain their previous standard of labor or sport activity.Downloads
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