Bone metabolism is a key factor for clinical outcome of tibial plateau fractures
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Bone metabolism is a key factor for clinical outcome of tibial plateau fractures. / Krause, Matthias; Alm, Lena; Berninger, Markus; Domnick, Christoph; Fehske, Kai; Frosch, Karl-Heinz; Herbst, Elmar; Korthaus, Alexander; Raschke, Michael; Hoffmann, Reinhard; “Fracture committee” of the German Knee Society.
In: EUR J TRAUMA EMERG S, Vol. 46, No. 6, 12.2020, p. 1227-1237.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Bone metabolism is a key factor for clinical outcome of tibial plateau fractures
AU - Krause, Matthias
AU - Alm, Lena
AU - Berninger, Markus
AU - Domnick, Christoph
AU - Fehske, Kai
AU - Frosch, Karl-Heinz
AU - Herbst, Elmar
AU - Korthaus, Alexander
AU - Raschke, Michael
AU - Hoffmann, Reinhard
AU - “Fracture committee” of the German Knee Society
PY - 2020/12
Y1 - 2020/12
N2 - PURPOSE: Given that tibial plateau fractures (TPF) are rare, they may pose a challenge to the treating surgeon due to their variety of complex fracture patterns. Numerous studies have identified potential fracture-specific, surgery-related, and patient-related risk factors for impaired patient outcomes. However, reports on the influence of bone metabolism on functional outcomes are missing.METHODS: In a retrospective multicenter cohort study, 122 TPF of 121 patients were analyzed with respect to radiological and clinical outcomes (Rasmussen) with a mean follow-up of 35.7 ± 24.9 months. The risk factor assessment included bone metabolism-affecting comorbidities and medication.RESULTS: The findings showed that 95.9% of the patients reported a good-to-excellent clinical outcome, and 97.4% reported a good-to-excellent radiological outcome. Logistic regression revealed that potentially impaired bone metabolism (IBM) was an independent risk factor for the clinical (p = 0.016) but not the radiological outcome (Table 4). Patients with 41-type B fractures and a potential IBM had a seven times higher risk to present a fair-to-poor clinical outcome [OR 7.45, 95 CI (4.30, 12.92)]. The most common objective impairment was a limited range of motion in 16.4% of the patients, especially in 41-type C fractures (p = 0.06). The individual failure analysis additionally identified surgery-related options for improvement.CONCLUSION: This study demonstrated that potential IBM was an independent risk factor for a poor-to-fair clinical outcome.
AB - PURPOSE: Given that tibial plateau fractures (TPF) are rare, they may pose a challenge to the treating surgeon due to their variety of complex fracture patterns. Numerous studies have identified potential fracture-specific, surgery-related, and patient-related risk factors for impaired patient outcomes. However, reports on the influence of bone metabolism on functional outcomes are missing.METHODS: In a retrospective multicenter cohort study, 122 TPF of 121 patients were analyzed with respect to radiological and clinical outcomes (Rasmussen) with a mean follow-up of 35.7 ± 24.9 months. The risk factor assessment included bone metabolism-affecting comorbidities and medication.RESULTS: The findings showed that 95.9% of the patients reported a good-to-excellent clinical outcome, and 97.4% reported a good-to-excellent radiological outcome. Logistic regression revealed that potentially impaired bone metabolism (IBM) was an independent risk factor for the clinical (p = 0.016) but not the radiological outcome (Table 4). Patients with 41-type B fractures and a potential IBM had a seven times higher risk to present a fair-to-poor clinical outcome [OR 7.45, 95 CI (4.30, 12.92)]. The most common objective impairment was a limited range of motion in 16.4% of the patients, especially in 41-type C fractures (p = 0.06). The individual failure analysis additionally identified surgery-related options for improvement.CONCLUSION: This study demonstrated that potential IBM was an independent risk factor for a poor-to-fair clinical outcome.
U2 - 10.1007/s00068-020-01537-4
DO - 10.1007/s00068-020-01537-4
M3 - SCORING: Journal article
C2 - 33151357
VL - 46
SP - 1227
EP - 1237
JO - EUR J TRAUMA EMERG S
JF - EUR J TRAUMA EMERG S
SN - 1863-9933
IS - 6
ER -