title: [Tibial plateau fractures in alpine skiing--return to the slopes or career end?].
abstract: BACKGROUND
  Fractures of the tibial plateau are among the most severe injuries of the knee joint and are often the result of sports accidents, especially skiing accidents.
  
  
  METHODS
  Between January 2003 and March 2009, a total of 37 skiers with tibial plateau fractures were treated operatively at Klinikum rechts der Isar, Munich (level I trauma center); 28 patients with a minimum follow-up of 24 months were included in this study. Sporting activity was determined at the time of injury and at the time of survey at an average follow-up of 49.0 months postoperatively.
  
  
  RESULTS
  At the time of the survey, 92.9% of all patients were engaged in sports; only 12 of the 28 patients returned to skiing. Of the competitive athletes (n = 5 at time of injury) no patient returned to competition. The number of different sporting activities declined significantly from 6.4 before the injury to 4.6 after the injury. The activity duration per week, being 5.0 hours at the time of injury, declined to 4.4 hours, although the difference is statistically not significant. The Lysholm score, 97.5 points before accident, illustrated a significant decline to 84.4 points. Activity levels according to the Tegner scale declined significantly from 6.1 to 4.7 after the tibial plateau fracture.
  
  
  CONCLUSIONS
  The majority of patients could not return to their previous level of activity. For patients playing competitive sports, the tibial plateau fracture can be a career ender. Overall, 92.9% of the patients returned to sports, but we noticed a post-injury shift toward activities with less impact. Only 12 of the 28 (42.9%) skiers with tibial plateau fractures returned to skiing.
authors.affiliation: Klinik für Allgemeine, Unfall-, Hand- und Plastische Chirurgie, Klinikum der Universität München.
authors.forename: D
authors.initials: D
authors.lastname: Müller
authors.affiliation: Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar der TU München.
authors.forename: G H
authors.initials: GH
authors.lastname: Sandmann
authors.affiliation: Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar der TU München.
authors.forename: F
authors.initials: F
authors.lastname: Martetschläger
authors.affiliation: Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar der TU München.
authors.forename: U
authors.initials: U
authors.lastname: Stöckle
authors.affiliation: Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar der TU München.
authors.forename: T M
authors.initials: TM
authors.lastname: Kraus
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012865:Skiing / Q000293:injuries*; D013978:Tibial Fractures / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome