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Klinische Ergebnisse und Arbeitsfähigkeit nach intraartikulärer proximaler Tibiafraktur
Pätzold, Robert; Bühren, Volker; Thannheimer, Andreas
Trauma und Berufskrankheit, 2018, Sonderheft Unfallmedizinische Tagung Hamburg, 16./17. Februar 2018, Volume 20 (Supplement 4), Seite 250-255, Berlin, Heidelberg: Springer, ISSN: 1436-6274 (Print); 1436-6282 (Online)
Material und Methoden:
Clinical results and ability to work after intra-articular proximal tibial fractures
Proximal intra-articular tibial fractures represent a challenge for the treating surgeon. The injuries can have far-reaching consequences for affected patients in both their private and occupational life.
Are there prognostic factors that influence the clinical outcome?
Material and methods:
All patients between 18 and 60 years with intra-articular proximal tibial fractures treated in the trauma hospital in Murnau and the Clinic in Garmisch Partenkirchen from the years 2007-2013 were included in the study. The subdivision of fractures was carried out according to the AO classification. Accompanying injuries of the knee joint and multiple injuries were documented. The Lysholm score, the WOMAC score and the Tegner activity index were used in the follow-up examination. In addition, the physical strain at the workplace was documented according to the REFA index 2 years after the accident.
Included in the study were 439 patients with proximal intra-articular tibial fractures. Unicondylar fractures were present in two thirds of the cases. In the case of bicondylar injuries the proportion with compartment syndrome was clearly increased with 23.8 % vs. 1.6 %. The follow-up period was 2.5 years. The Tegner activity index decreased from 5.9 before the accident to 4.2 for B1 injuries and to 3.4 for C3 injuries. The Lysholm score after an average of 2.5 years was 84.3 for B1 fractures and 70.6 for C3 fractures. The presence of compartment syndrome and multiple injuries had a negative influence on all scores. After B1 fractures 80 % of the patients could return to work at their previous workplace and 71 % after C3 fractures. The proportion of patients who could no longer return to work after proximal tibial fractures was the highest for C3 fractures with 64 %. The REFA index was reduced from 2.6 to 2.0 for B1 fractures and from 2.5 to 1.5 for C3 fractures.
The clinical long-term results and the possible return to physically demanding work are dependent on the type of fracture and the accompanying injuries, such as compartment syndrome and possible multiple injuries.
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Zeitschriftenbeitrag / Forschungsergebnis
Trauma und Berufskrankheit
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