Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Sep;41(9):1865-1873.
doi: 10.1007/s00264-017-3566-3. Epub 2017 Jul 18.

Functional outcome of intra-articular tibial plateau fractures: the impact of posterior column fractures

Juriaan van den Berg  1 , Maike Reul  2 , Menno Nunes Cardozo  1 , Anastasiya Starovoyt  1 , Eric Geusens  3 , Stefaan Nijs  2   4 , Harm Hoekstra  5   6
Affiliations

Functional outcome of intra-articular tibial plateau fractures: the impact of posterior column fractures

Juriaan van den Berg et al. Int Orthop. 2017 Sep.

Abstract

Abastract: INTRODUCTION: Although regularly ignored, there is growing evidence that posterior tibial plateau fractures affect the functional outcome. The goal of this study was to assess the incidence of posterior column fractures and its impact on functional outcome and general health status. We aimed to identify all clinical variables that influence the outcome and improve insights in the treatment strategies.

Methods: A retrospective cohort study including 218 intra-articular tibial plateau fractures was conducted. All fractures were reclassified and applied treatment was assessed according to the updated three-column concept. Relevant demographic and clinical variables were studied. The patient reported outcome was assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS).

Results: Median follow-up was 45.5 (IQR 24.9-66.2) months. Significant outcome differences between operatively and non-operatively treated patients were found for all KOOS subscales. The incidence of posterior column fractures was 61.9%. Posterior column fractures, sagittal malalignment and an increased complication rate were associated with poor outcome. Patients treated according to the updated three-column concept, showed significantly better outcome scores than those patients who were not. We could not demonstrate the advantage of posterior column fracture fixation, due to a limited patient size.

Conclusion: Our data indicates that implementation of the updated three-column classification concept may improve the surgical outcome of tibial plateau fractures. Failure to recognize posterior column fractures may lead to inappropriate utilization of treatment techniques. The current concept allows us to further substantiate the importance of reduction and fixation of posterior column fractures with restoration of the sagittal alignment.

Level of evidence: 3.

Keywords: Functional outcome; Posterior column; Three-column classification; Tibial plateau fractures.

PubMed Disclaimer

References

    1. Injury. 2010 Oct;41(10 ):986-95 - PubMed
    1. J Orthop Trauma. 2004 Nov-Dec;18(10):649-57 - PubMed
    1. J Bone Joint Surg Am. 2014 Jan 15;96(2):144-50 - PubMed
    1. J Orthop Trauma. 1995;9(4):273-7 - PubMed
    1. Orthop Traumatol Surg Res. 2015 Jun;101(4):477-82 - PubMed

MeSH terms

LinkOut - more resources