title: Comparative Analysis of Clinical Outcomes of Tibial Plateau Fractures and Computed Tomography Examinations.
abstract: BACKGROUND
  The aim of the study was to evaluate the outcomes of treatment of tibial plateau fractures. Based on CT examination, we set out to determine what factors were associated with a poor functional outcome.
  
  
  METHODS
  The study involved 13 patients after surgery for tibial plateau fracture by locking plate osteosynthesis. CT studies using a MARS application were performed. The presence of subchondral defects was evaluated, including their area and depth. The reduction and widening of the tibial plateau were measured. The study data were correlated with the clinical outcome: pain according to a VAS scale, knee joint range of motion and the subjective IKDC score.
  
  
  RESULTS
  Bone defects were observed in the majority of patients. On the basis of surface reconstruction, it was possible to accurately evaluate the articular step-off of the tibial plateau, which closely correlated with the range of motion and the subjective IKDC score (p <0.05). A correlation was also observed between widening of the lateral condyle and the IKDC score and pain level in the VAS scale (p<0.05).
  
  
  CONCLUSIONS
  1. Articular step-off and widening of the lateral condyle strongly correlates with the clinical outcome of tibial plateau fracture treatment. 2. The presence and extent of subchondral bone defects in the tibial plateau are related to knee pain in patients but have no effect on the range of motion and the IKDC score. 3. Bone graft remodeling cannot be fully assessed despite the use of MARS in CT imaging.
authors.affiliation: Department of Traumatology and Orthopaedics, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Piątkowski
authors.affiliation: Department of Traumatology and Orthopaedics, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kwiatkowski
authors.affiliation: Department of Traumatology and Orthopaedics, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Piekarczyk
authors.affiliation: Division of Radiology, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Zegadło
authors.affiliation: Division of Radiology, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Rafał
authors.initials: R
authors.lastname: Rojkowski
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013977:Tibia / Q000000981:diagnostic imaging*; D013978:Tibial Fractures / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome