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Article

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

1
Discipline of Orthopaedics and Trauma, Centre for Orthopaedic and Trauma Research, University of Adelaide, Adelaide, SA 5005, Australia
2
Orthopaedic and Trauma Service, Royal Adelaide Hospital, Adelaide, SA 5000, Australia
*
Author to whom correspondence should be addressed.
Academic Editor: Christian Carulli
J. Clin. Med. 2022, 11(1), 138; https://doi.org/10.3390/jcm11010138
Received: 16 October 2021 / Revised: 23 December 2021 / Accepted: 23 December 2021 / Published: 27 December 2021
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. View Full-Text
Keywords: tibial plateau fracture; fracture reduction; patient-reported outcome; fracture fixation; articular step tibial plateau fracture; fracture reduction; patient-reported outcome; fracture fixation; articular step
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MDPI and ACS Style

Kitchen, D.S.; Richards, J.; Smitham, P.J.; Atkins, G.J.; Solomon, L.B. Does Time to Theatre Affect the Ability to Achieve Fracture Reduction in Tibial Plateau Fractures? J. Clin. Med. 2022, 11, 138. https://doi.org/10.3390/jcm11010138

AMA Style

Kitchen DS, Richards J, Smitham PJ, Atkins GJ, Solomon LB. Does Time to Theatre Affect the Ability to Achieve Fracture Reduction in Tibial Plateau Fractures? Journal of Clinical Medicine. 2022; 11(1):138. https://doi.org/10.3390/jcm11010138

Chicago/Turabian Style

Kitchen, David Stuart, Jack Richards, Peter J. Smitham, Gerald J. Atkins, and Lucian B. Solomon. 2022. "Does Time to Theatre Affect the Ability to Achieve Fracture Reduction in Tibial Plateau Fractures?" Journal of Clinical Medicine 11, no. 1: 138. https://doi.org/10.3390/jcm11010138

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