AI Article Synopsis
- The study aimed to compare the patient-reported outcomes of individuals with hyperextension varus tibial plateau (HEVTP) fractures to those with non-HEVTP fractures at a Level 1 Trauma Center.
- Out of 207 patients analyzed, HEVTP fractures were more common in younger, predominantly male patients with a higher body mass index and were associated with greater ligamentous and vascular injuries.
- Although overall physical function scores were similar, HEVTP patients reported significantly lower scores in quality of life and other specific measures, indicating that HEVTP fractures may have more negative impacts on certain aspects of recovery.
Article Abstract
Objectives: Compare patient-reported outcome measures between hyperextension varus tibial plateau (HEVTP) fracture patterns to non-HEVTP fracture patterns.
Design: Retrospective study.
Setting: Single academic Level 1 Trauma Center.
Patient Selection Criteria: All patients who underwent fixation of a tibial plateau fracture from 2016 to 2021 were collected. Exclusion criteria included inaccurate Current Procedural Terminology code, ipsilateral compartment syndrome, bilateral fractures, incomplete medical records, or follow-up <10 months.
Outcome Measures And Comparisons: In patients who underwent fixation of a tibial plateau fracture, compare Patient-Reported Outcomes Measurement Information System-Physical Function, PROMIS Preference, and Knee Injury and Osteoarthritis Outcome Score (KOOS) between patients with a HEVTP pattern with those without.
Results: Two-hundred and seven patients were included, of which 17 (8%) had HEVTP fractures. Compared with non-HEVTP fracture patterns, patients with HEVTP injuries were younger (42.6 vs. 51.0, P = 0.025), more commonly male (71% vs. 44%, P = 0.033), and had higher body mass index (32.8 vs. 28.0, P = 0.05). HEVTP fractures had significantly more ligamentous knee (29% vs. 6%, P = 0.007) and vascular (12% vs. 1%, P = 0.035) injuries. Patient-Reported Outcomes Measurement Information System-Physical Function scores were similar between groups; however, PROMIS-Preference (0.37 vs. 0.51, P = 0.017) was significantly lower in HEVTP fractures. KOOS pain, activities of daily living, and quality-of-life scores were statistically lower in HEVTP fractures, but only KOOS quality-of-life was clinically relevant (41.7 vs. 59.3, P = 0.004).
Conclusions: The HEVTP fracture pattern, whether unicondylar or bicondylar, was associated with a higher rate of ligamentous and vascular injuries compared with non-HEVTP fracture patterns. They were also associated with worse health-related quality of life at midterm follow-up.
Level Of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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