gms | German Medical Science

Objective: The correlation between malreduction and clinical outcome is not yet fully understood in tibial plateau fractures. This work intends to clarify the correlation between fracture classification, functional Rasmussen kneescore and modified radiological rasmussen score.

Methods: Patients with a tibial plateau fracture treated surgically from 2014-2019 were included in this monocenter, retrospective study of a level I trauma center. Fractures were classified according to Schatzker/AO and Moore. One year postoperatively, conventional radiographs were evaluated in 2 planes according to the modified radiological Rasmussen score. Furthermore, patients received a clinical examination evaluating the functional Rasmussen score at the time before injury, one year after injury, and at the time of final follow-up.

Results: A total of 50 patients (58% females, 42% males, 47.4 ± 11.4 years mean age) were included in the study with a mean follow up of 3.9 years (± 569.59 days). There were 25 simple fractures (Schatzker I-III) and 25 more complex fractures (Schatzker IV-VI, Moore fractures).

Absolute functional outcome scorewas significantly worse one year postoperatively than before trauma for both simple and complex fractures. However, at further follow-up, simple fractures did not show significantly worse score than before trauma, but complex fractures did. In the radiological Rasmussen score after one year, there is neither a significant difference between the simple and the complex fractures nor a correlation to the clinical results. Both groups achieve an average score corresponding to a "good" result.

Conclusion: After surgical treatment of tibial plateau fractures, the overall functional outcome is "excellent". The results for simple fractures are superior to complex fractures in both the short and medium term. Because of improved surgical techniques and outcomes, the radiological Rasmussen score does not appear to have sufficient discriminatory power to distinguish between simple and complex fractures. Furthermore, there is no correlation with functional score, which explains the need for a more detailed radiological evaluation.