Functional outcomes after surgical treatment of tibial plateau fractures

Tibial plateau fractures are significant because of its intra-articular nature. In this study, we aim to evaluate the functional outcomes of tibial plateau fractures after surgical treatment and to determine the rates of return to work and sports after recovery. This is a retrospective study conducted at a single tertiary-level institution. Forty-one patients with tibial plateau fractures were operatively treated during our study period. Patient information including injury mechanism, surgical treatment and associated injuries were documented. Pre-operative and post-operative radiographs were reviewed to confirm Schatzker type and adequacy of reduction. Follow up data for thirty-one patients was obtained nineteen to forty-two months post-surgery. All patients were administered functional outcome questionnaires using the Western Ontario and McMaster University Osteoarthritis index (WOMAC) and Short Form 36 (SF-36) general health survey. Data regarding return to work and sports was also collected. Data analysis was done to determine the relationship between fracture type, adequacy of reduction and functional outcome. The average WOMAC score for patients with Schatzker I to III was 6.3 out of a maximum score of 96, significantly lower than the Schatzker IV to VI group, whose average score was 18.4 (p = 0.0012). The SF-36 score for the Schatzker I to III group was also significantly higher than the VI to VI group (p = 0.0031). 71% of patients reported partial to full return to work, while 65% of patients did not return to sports after injury. In conclusion, the functional outcome of operatively treated tibial plateau fractures is satisfactory, with poorer functional outcome being associated with higher energy fractures. (Schatzker IV to VI) Majority of patients were able to return to their pre-injury employment but only a small minority were able to return to sports.