Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

Outcomes after ORIF of Bicondylar Schatzker VI (AO type C) Tibial Plateau Fractures in an Elderly Population

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Health care utilization and outcomes in older adults after Traumatic Brain Injury: A CENTER-TBI study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. A high fraction of inspired oxygen may increase mortality in intubated trauma patients - A retrospective cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Prehospital triage of trauma patients before and after implementation of a regional triage guideline

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Hemorrhage and saline resuscitation are associated with epigenetic and proteomic reprogramming in the rat lung

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

BACKGROUND: The surgical management of bicondylar tibial plateau (BTP) fractures in elderly patients aims to restore knee stability while minimizing soft tissue complications. The purpose of this study was to compare injury characteristics and surgical outcomes after ORIF of BTP fractures (AO/OTA 41-C (Schatzker VI)) in young (< 50 years) versus elderly (> 65 years) patients.

METHODS: A retrospective cohort study was conducted using data from two American College of Surgeons (ACS) level I trauma centers. Inclusion criteria were: (1) age 18 years or older, (2) bicondylar tibial plateau fracture (AO/OTA 41-C or Schatzker VI), (3) treatment with ORIF, and (4) minimum of 6 months follow-up. Patients between 50 and 65 years of age were excluded. Data collection was performed by reviewing electronic medical records, operative reports, and radiology reports.

RESULTS: We identified 323 patients (61% male) with 327 BTP fractures and a median follow-up of 685 days. There were 230 young patients (71%) < 50 years and 93 elderly patients (29%) >6 5 years at time of presentation. Elderly patients were significantly more likely to have a low energy mechanism of injury (44.6 vs. 16.2%, p < 0.001), and present with diabetes (19.4 vs. 4.4%, p < 0.001) or coronary artery disease (12.9 vs. 1.3%, p < 0.001). Elderly patients were also significantly less likely to undergo staged management with initial knee-spanning external fixation followed by delayed ORIF (19.2 vs. 33.9%, p = 0.008). Elderly patients had a lower arc of motion at final follow-up (105 vs. 113°, p < 0.001) and reduced PROMIS-10 function scores (43.8 vs. 49.8, p = 0.013). No differences were observed in rates of superficial infection, deep infection, reoperation, or EQ-5D scores between age groups.

CONCLUSIONS: This is the largest study to compare injury characteristics and outcomes after ORIF of BTP fractures according to age. Elderly patients (age > 65 years) sustained BTP fractures by lower energy mechanisms than their younger counterparts with similar fracture patterns and were often managed with ORIF. The results of this study suggest that ORIF of BTP fractures in elderly patients is associated with similar complication rates and outcomes as in younger patients despite higher comorbidities and poorer bone quality in the elderly population.

Original languageEnglish
JournalInjury
Volume53
Issue number6
Pages (from-to)2226-2232
Number of pages7
ISSN0020-1383
DOIs
Publication statusPublished - Jun 2022

Bibliographical note

Copyright © 2022 Elsevier Ltd. All rights reserved.

    Research areas

  • Bicondylar, Geriatric, ORIF, Tibial plateau

ID: 78315005