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Mismatch between Clinical–Functional and Radiological Outcome in Tibial Plateau Fractures: A Retrospective Study

Background: The evaluation of tibial plateau fractures (TPF) encompasses the assessment of clinical–functional and radiological parameters. In this study, the authors aimed to investigate the potential correlation between these parameters by utilizing both the clinical–functional and the modified ra...

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Autores principales: Bormann, Markus, Bitschi, David, Neidlein, Claas, Berthold, Daniel P., Jörgens, Maximilian, Pätzold, Robert, Watrinet, Julius, Böcker, Wolfgang, Holzapfel, Boris Michael, Fürmetz, Julian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10488212/
https://www.ncbi.nlm.nih.gov/pubmed/37685650
http://dx.doi.org/10.3390/jcm12175583
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author Bormann, Markus
Bitschi, David
Neidlein, Claas
Berthold, Daniel P.
Jörgens, Maximilian
Pätzold, Robert
Watrinet, Julius
Böcker, Wolfgang
Holzapfel, Boris Michael
Fürmetz, Julian
author_facet Bormann, Markus
Bitschi, David
Neidlein, Claas
Berthold, Daniel P.
Jörgens, Maximilian
Pätzold, Robert
Watrinet, Julius
Böcker, Wolfgang
Holzapfel, Boris Michael
Fürmetz, Julian
author_sort Bormann, Markus
collection PubMed
description Background: The evaluation of tibial plateau fractures (TPF) encompasses the assessment of clinical–functional and radiological parameters. In this study, the authors aimed to investigate the potential correlation between these parameters by utilizing both the clinical–functional and the modified radiological Rasmussen score. Methods: In this retrospective monocentric study conducted at a level-I trauma center, patients who underwent surgery between January 2014 and December 2019 due to a TPF were included. The clinical–functional Rasmussen score prior to the injury, at 1-year postoperatively, and during the last follow-up (minimum 18 months) was assessed using a standardized questionnaire. Additionally, the modified radiological Rasmussen score was determined at the 1-year postoperative mark using conventional radiographs in two planes. Results: A total of 50 patients were included in this study, comprising 40% (n = 20) men, and 60% (n = 30) women, with an average age of 47 ± 11.8 years (range 26–73 years old). Among them, 52% (n = 26) had simple fractures (classified according to Schatzker I–III), while 48% (n = 24; according to Schatzker IV–VI) had complex fractures. The mean follow-up was 3.9 ± 1.6 years (range 1.6–7.5 years). The functional Rasmussen score assessed before the injury and at follow-up showed an “excellent” average result. However, there was a significant difference in the values of complex fractures compared to before the injury. One year postoperatively, both the clinical–functional score and the modified radiological score demonstrated a “good” average result. The “excellent” category was more frequently observed in the functional score, while the “fair” category was more common in the radiological score. There was no agreement between the categories in both scores in 66% of the cases. Conclusions: The data from this retrospective study demonstrated that patients with TPF are able to achieve a nearly equivalent functional level in the medium-term after a prolonged recovery period, comparable to their pre-injury state. However, it is important to note that the correlation between clinical–functional and radiological parameters is limited. Consequently, in order to create prospective outcome scores, it becomes crucial to objectively assess the multifaceted nature of TPF injuries in more detail, both clinically and radiologically.
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spelling pubmed-104882122023-09-09 Mismatch between Clinical–Functional and Radiological Outcome in Tibial Plateau Fractures: A Retrospective Study Bormann, Markus Bitschi, David Neidlein, Claas Berthold, Daniel P. Jörgens, Maximilian Pätzold, Robert Watrinet, Julius Böcker, Wolfgang Holzapfel, Boris Michael Fürmetz, Julian J Clin Med Article Background: The evaluation of tibial plateau fractures (TPF) encompasses the assessment of clinical–functional and radiological parameters. In this study, the authors aimed to investigate the potential correlation between these parameters by utilizing both the clinical–functional and the modified radiological Rasmussen score. Methods: In this retrospective monocentric study conducted at a level-I trauma center, patients who underwent surgery between January 2014 and December 2019 due to a TPF were included. The clinical–functional Rasmussen score prior to the injury, at 1-year postoperatively, and during the last follow-up (minimum 18 months) was assessed using a standardized questionnaire. Additionally, the modified radiological Rasmussen score was determined at the 1-year postoperative mark using conventional radiographs in two planes. Results: A total of 50 patients were included in this study, comprising 40% (n = 20) men, and 60% (n = 30) women, with an average age of 47 ± 11.8 years (range 26–73 years old). Among them, 52% (n = 26) had simple fractures (classified according to Schatzker I–III), while 48% (n = 24; according to Schatzker IV–VI) had complex fractures. The mean follow-up was 3.9 ± 1.6 years (range 1.6–7.5 years). The functional Rasmussen score assessed before the injury and at follow-up showed an “excellent” average result. However, there was a significant difference in the values of complex fractures compared to before the injury. One year postoperatively, both the clinical–functional score and the modified radiological score demonstrated a “good” average result. The “excellent” category was more frequently observed in the functional score, while the “fair” category was more common in the radiological score. There was no agreement between the categories in both scores in 66% of the cases. Conclusions: The data from this retrospective study demonstrated that patients with TPF are able to achieve a nearly equivalent functional level in the medium-term after a prolonged recovery period, comparable to their pre-injury state. However, it is important to note that the correlation between clinical–functional and radiological parameters is limited. Consequently, in order to create prospective outcome scores, it becomes crucial to objectively assess the multifaceted nature of TPF injuries in more detail, both clinically and radiologically. MDPI 2023-08-27 /pmc/articles/PMC10488212/ /pubmed/37685650 http://dx.doi.org/10.3390/jcm12175583 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bormann, Markus
Bitschi, David
Neidlein, Claas
Berthold, Daniel P.
Jörgens, Maximilian
Pätzold, Robert
Watrinet, Julius
Böcker, Wolfgang
Holzapfel, Boris Michael
Fürmetz, Julian
Mismatch between Clinical–Functional and Radiological Outcome in Tibial Plateau Fractures: A Retrospective Study
title Mismatch between Clinical–Functional and Radiological Outcome in Tibial Plateau Fractures: A Retrospective Study
title_full Mismatch between Clinical–Functional and Radiological Outcome in Tibial Plateau Fractures: A Retrospective Study
title_fullStr Mismatch between Clinical–Functional and Radiological Outcome in Tibial Plateau Fractures: A Retrospective Study
title_full_unstemmed Mismatch between Clinical–Functional and Radiological Outcome in Tibial Plateau Fractures: A Retrospective Study
title_short Mismatch between Clinical–Functional and Radiological Outcome in Tibial Plateau Fractures: A Retrospective Study
title_sort mismatch between clinical–functional and radiological outcome in tibial plateau fractures: a retrospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10488212/
https://www.ncbi.nlm.nih.gov/pubmed/37685650
http://dx.doi.org/10.3390/jcm12175583
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