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Does Time to Theatre Affect the Ability to Achieve Fracture Reduction in Tibial Plateau Fractures?

Surgical management of displaced tibial plateau fracture (TPF) is often delayed due to accompanying soft tissue injuries sustained at the time of injury. The primary aim of this study was to assess the effect of time to surgery on fracture reduction in cases of TPF. The secondary aim was to assess t...

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Autores principales: Kitchen, David Stuart, Richards, Jack, Smitham, Peter J., Atkins, Gerald J., Solomon, Lucian B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745337/
https://www.ncbi.nlm.nih.gov/pubmed/35011877
http://dx.doi.org/10.3390/jcm11010138
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author Kitchen, David Stuart
Richards, Jack
Smitham, Peter J.
Atkins, Gerald J.
Solomon, Lucian B.
author_facet Kitchen, David Stuart
Richards, Jack
Smitham, Peter J.
Atkins, Gerald J.
Solomon, Lucian B.
author_sort Kitchen, David Stuart
collection PubMed
description Surgical management of displaced tibial plateau fracture (TPF) is often delayed due to accompanying soft tissue injuries sustained at the time of injury. The primary aim of this study was to assess the effect of time to surgery on fracture reduction in cases of TPF. The secondary aim was to assess the effect of preoperative demographics and residual articular step on Lysholm Scores and Knee Injury and Osteoarthritis Outcome Scores (KOOS) following fixation. Patients between 2006 and 2017, managed by a single surgeon, were prospectively enrolled in the study. Reduction of articular step, defined as <2 mm, was assessed by a single blinded examiner. A total of 117 patients were enrolled, 52 with Schatzker II, 4 with Schatzker IV, and 61 with Schatzker VI fractures. Patients were followed up to a mean of 3.9 years. Analysis showed that the ability to achieve fracture reduction was negatively influenced by time to theatre, with the odds of achieving reduction decreasing 17% with each subsequent day post injury (p = 0.002). Furthermore, an increased time to theatre was associated with a reduced Lysholm score at one year (p = 0.01). The ability to achieve fracture reduction did not influence PROMs within the study period. We conclude that delay in surgical fixation negatively affects fracture reduction in TPF and may delay recovery. However, residual articular step does not necessarily influence PROMs over the mid-term.
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spelling pubmed-87453372022-01-11 Does Time to Theatre Affect the Ability to Achieve Fracture Reduction in Tibial Plateau Fractures? Kitchen, David Stuart Richards, Jack Smitham, Peter J. Atkins, Gerald J. Solomon, Lucian B. J Clin Med Article Surgical management of displaced tibial plateau fracture (TPF) is often delayed due to accompanying soft tissue injuries sustained at the time of injury. The primary aim of this study was to assess the effect of time to surgery on fracture reduction in cases of TPF. The secondary aim was to assess the effect of preoperative demographics and residual articular step on Lysholm Scores and Knee Injury and Osteoarthritis Outcome Scores (KOOS) following fixation. Patients between 2006 and 2017, managed by a single surgeon, were prospectively enrolled in the study. Reduction of articular step, defined as <2 mm, was assessed by a single blinded examiner. A total of 117 patients were enrolled, 52 with Schatzker II, 4 with Schatzker IV, and 61 with Schatzker VI fractures. Patients were followed up to a mean of 3.9 years. Analysis showed that the ability to achieve fracture reduction was negatively influenced by time to theatre, with the odds of achieving reduction decreasing 17% with each subsequent day post injury (p = 0.002). Furthermore, an increased time to theatre was associated with a reduced Lysholm score at one year (p = 0.01). The ability to achieve fracture reduction did not influence PROMs within the study period. We conclude that delay in surgical fixation negatively affects fracture reduction in TPF and may delay recovery. However, residual articular step does not necessarily influence PROMs over the mid-term. MDPI 2021-12-27 /pmc/articles/PMC8745337/ /pubmed/35011877 http://dx.doi.org/10.3390/jcm11010138 Text en © 2021 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
Kitchen, David Stuart
Richards, Jack
Smitham, Peter J.
Atkins, Gerald J.
Solomon, Lucian B.
Does Time to Theatre Affect the Ability to Achieve Fracture Reduction in Tibial Plateau Fractures?
title Does Time to Theatre Affect the Ability to Achieve Fracture Reduction in Tibial Plateau Fractures?
title_full Does Time to Theatre Affect the Ability to Achieve Fracture Reduction in Tibial Plateau Fractures?
title_fullStr Does Time to Theatre Affect the Ability to Achieve Fracture Reduction in Tibial Plateau Fractures?
title_full_unstemmed Does Time to Theatre Affect the Ability to Achieve Fracture Reduction in Tibial Plateau Fractures?
title_short Does Time to Theatre Affect the Ability to Achieve Fracture Reduction in Tibial Plateau Fractures?
title_sort does time to theatre affect the ability to achieve fracture reduction in tibial plateau fractures?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745337/
https://www.ncbi.nlm.nih.gov/pubmed/35011877
http://dx.doi.org/10.3390/jcm11010138
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