Cargando…

Effects of surgical approaches and morphological characteristics on the follow up outcomes of patients with posterolateral tibial plateau fractures

This study aimed to study the effects of surgical approaches and identify the morphological characteristics associated with the 1-year follow-up outcome of patients with posterolateral tibial plateau fractures after successful surgery. We followed 200 postoperative patients for 1 year. The modified...

Descripción completa

Detalles Bibliográficos
Autores principales: Huo, Yongfeng, Xu, Gang, Yin, Zhaoyang, Yu, Jian, Sun, Xiao, Li, Leiming, Gu, Guangxue, Sheng, Luxin, Sun, Hong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220780/
https://www.ncbi.nlm.nih.gov/pubmed/32332643
http://dx.doi.org/10.1097/MD.0000000000019854
_version_ 1783533240846385152
author Huo, Yongfeng
Xu, Gang
Yin, Zhaoyang
Yu, Jian
Sun, Xiao
Li, Leiming
Gu, Guangxue
Sheng, Luxin
Sun, Hong
author_facet Huo, Yongfeng
Xu, Gang
Yin, Zhaoyang
Yu, Jian
Sun, Xiao
Li, Leiming
Gu, Guangxue
Sheng, Luxin
Sun, Hong
author_sort Huo, Yongfeng
collection PubMed
description This study aimed to study the effects of surgical approaches and identify the morphological characteristics associated with the 1-year follow-up outcome of patients with posterolateral tibial plateau fractures after successful surgery. We followed 200 postoperative patients for 1 year. The modified Hospital for Special Knee Surgery score (HSS score) was used to evaluate the functional recovery of the knee. We supposed 4 morphological characteristics in CT images acting as possible risk factors, including the anteroposterior diameters of posterolateral broken bone fragments (fragment-diameter), the damage to the posterolateral cortex of the tibial head (cortex-damage), the combinational fracture of the proximal fibula (fibula-fracture) or fracture of the medial tibial condyle (medial-condyle-fracture). Multivariate regression models were used to analyze the effect of these factors on the HSS score after adjusting the 2 surgical approaches and other confounders. The average HSS score was 85.1 ± 5.8 for all the patients. We treated 155 patients with the anterolateral approach and 45 patients with the posterolateral approach. The surgical approach, fragment-diameter, fibula-fracture, and medial-condyle-fracture were correlated with the HSS scores (P < .05). After adjusting for the above factors, the Schatzker type, age and gender, compared with anterolateral approach, the posterolateral approach could improve the HSS scores by an average of 3.7 points. The fragment-diameter <20 mm and posterolateral approach interacted on the HSS scores. Comparing posterolateral and anterolateral approaches, we found that the HSS scores of patients with fragment-diameter <20 mm increased by 6.1 points (95% CI: 4.1–8.2) in the posterolateral approach, while those with fragment-diameter ≥20 mm did not significantly improve the HSS scores. The surgical approach, fragment-diameter, fibula-fracture, and medial-condyle-fracture were independent risk factors associated with the follow-up outcome of patients with posterolateral tibial plateau fractures after successful surgery. The posterolateral approach could significantly improve the HSS score in the studied hospital.
format Online
Article
Text
id pubmed-7220780
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-72207802020-06-15 Effects of surgical approaches and morphological characteristics on the follow up outcomes of patients with posterolateral tibial plateau fractures Huo, Yongfeng Xu, Gang Yin, Zhaoyang Yu, Jian Sun, Xiao Li, Leiming Gu, Guangxue Sheng, Luxin Sun, Hong Medicine (Baltimore) 7100 This study aimed to study the effects of surgical approaches and identify the morphological characteristics associated with the 1-year follow-up outcome of patients with posterolateral tibial plateau fractures after successful surgery. We followed 200 postoperative patients for 1 year. The modified Hospital for Special Knee Surgery score (HSS score) was used to evaluate the functional recovery of the knee. We supposed 4 morphological characteristics in CT images acting as possible risk factors, including the anteroposterior diameters of posterolateral broken bone fragments (fragment-diameter), the damage to the posterolateral cortex of the tibial head (cortex-damage), the combinational fracture of the proximal fibula (fibula-fracture) or fracture of the medial tibial condyle (medial-condyle-fracture). Multivariate regression models were used to analyze the effect of these factors on the HSS score after adjusting the 2 surgical approaches and other confounders. The average HSS score was 85.1 ± 5.8 for all the patients. We treated 155 patients with the anterolateral approach and 45 patients with the posterolateral approach. The surgical approach, fragment-diameter, fibula-fracture, and medial-condyle-fracture were correlated with the HSS scores (P < .05). After adjusting for the above factors, the Schatzker type, age and gender, compared with anterolateral approach, the posterolateral approach could improve the HSS scores by an average of 3.7 points. The fragment-diameter <20 mm and posterolateral approach interacted on the HSS scores. Comparing posterolateral and anterolateral approaches, we found that the HSS scores of patients with fragment-diameter <20 mm increased by 6.1 points (95% CI: 4.1–8.2) in the posterolateral approach, while those with fragment-diameter ≥20 mm did not significantly improve the HSS scores. The surgical approach, fragment-diameter, fibula-fracture, and medial-condyle-fracture were independent risk factors associated with the follow-up outcome of patients with posterolateral tibial plateau fractures after successful surgery. The posterolateral approach could significantly improve the HSS score in the studied hospital. Wolters Kluwer Health 2020-04-24 /pmc/articles/PMC7220780/ /pubmed/32332643 http://dx.doi.org/10.1097/MD.0000000000019854 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 7100
Huo, Yongfeng
Xu, Gang
Yin, Zhaoyang
Yu, Jian
Sun, Xiao
Li, Leiming
Gu, Guangxue
Sheng, Luxin
Sun, Hong
Effects of surgical approaches and morphological characteristics on the follow up outcomes of patients with posterolateral tibial plateau fractures
title Effects of surgical approaches and morphological characteristics on the follow up outcomes of patients with posterolateral tibial plateau fractures
title_full Effects of surgical approaches and morphological characteristics on the follow up outcomes of patients with posterolateral tibial plateau fractures
title_fullStr Effects of surgical approaches and morphological characteristics on the follow up outcomes of patients with posterolateral tibial plateau fractures
title_full_unstemmed Effects of surgical approaches and morphological characteristics on the follow up outcomes of patients with posterolateral tibial plateau fractures
title_short Effects of surgical approaches and morphological characteristics on the follow up outcomes of patients with posterolateral tibial plateau fractures
title_sort effects of surgical approaches and morphological characteristics on the follow up outcomes of patients with posterolateral tibial plateau fractures
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220780/
https://www.ncbi.nlm.nih.gov/pubmed/32332643
http://dx.doi.org/10.1097/MD.0000000000019854
work_keys_str_mv AT huoyongfeng effectsofsurgicalapproachesandmorphologicalcharacteristicsonthefollowupoutcomesofpatientswithposterolateraltibialplateaufractures
AT xugang effectsofsurgicalapproachesandmorphologicalcharacteristicsonthefollowupoutcomesofpatientswithposterolateraltibialplateaufractures
AT yinzhaoyang effectsofsurgicalapproachesandmorphologicalcharacteristicsonthefollowupoutcomesofpatientswithposterolateraltibialplateaufractures
AT yujian effectsofsurgicalapproachesandmorphologicalcharacteristicsonthefollowupoutcomesofpatientswithposterolateraltibialplateaufractures
AT sunxiao effectsofsurgicalapproachesandmorphologicalcharacteristicsonthefollowupoutcomesofpatientswithposterolateraltibialplateaufractures
AT lileiming effectsofsurgicalapproachesandmorphologicalcharacteristicsonthefollowupoutcomesofpatientswithposterolateraltibialplateaufractures
AT guguangxue effectsofsurgicalapproachesandmorphologicalcharacteristicsonthefollowupoutcomesofpatientswithposterolateraltibialplateaufractures
AT shengluxin effectsofsurgicalapproachesandmorphologicalcharacteristicsonthefollowupoutcomesofpatientswithposterolateraltibialplateaufractures
AT sunhong effectsofsurgicalapproachesandmorphologicalcharacteristicsonthefollowupoutcomesofpatientswithposterolateraltibialplateaufractures