The functional outcome and complication rates in tibial plateau fractures: A comparison between three different classification systems.

Abstract

Tibial plateau fractures are relatively common injuries, but research comparing the functional outcomes using different classification systems is scarce. This study aimed to analyse complication rates and functional outcomes in tibial plateau fractures by comparing three classification systems: Schatzker, AO/OTA, and the three-column classification system. A cross-sectional study was conducted on 125 consecutive tibial plateau fractures treated at our institution between 2016 and 2021. Functional outcomes were assessed using the International Knee Documentation Committee (IKDC) and Oxford Knee scores. Demographic data and information on postoperative complications were obtained from our institutional digital database. Of the 62 patients who met the inclusion criteria, the most significant functional decline was observed in AO/OTA C3 fractures, and three-column fractures of the tibial plateau (IKDC change: -38.4 ± 28.7; P = 0.004; and -32.2 ± 30.9; P = 0.022, respectively; and Oxford score change: -16.5 ± 14.2; P = 0.005; and -15.2 ± 12.3; P = 0.008; respectively). A strong correlation was found between the AO/OTA classification and the number of complications (R = 0.956, P = 0.005), but no correlation was found between age and functional decline. Compared with Schatzker's classification the AO/OTA classification is a better tool for the prediction of the functional outcome and complication rates in patients with tibial plateau fractures. AO/OTA C3 fractures were associated with the highest functional decline. There was no significant correlation between functional decline and the patient's age.