title: Lost to follow-up: reasons and outcomes following tibial plateau fractures.
abstract: BACKGROUND
  Different reasons for lost to follow-up are assumed. Besides "objective" reasons, "subjective" reasons and satisfaction contribute to treatment adherence. Retrospective studies usually lack the possibility of acquisition of additional outcome information. Purpose of this study was to determine outcome and factors for patients not returning for follow-up.
  
  
  METHODS
  Between 2002 and 2009, 380 patients underwent internal fixation for tibial plateau fractures. Short Musculoskeletal Function Assessment (SMFA) was collected at 6, 12, and 24 months as long as patients returned for follow-up. Pain and range of motion were measured. Records were studied for reasons of termination of follow-up. Statistical analysis was performed comparing lost to follow-up versus continued office visits regarding demographics, contributing factors, and SMFA.
  
  
  RESULTS
  Two hundred fifty-nine patients were followed until treatment was completed (PRN), while 120 patients (32 %) terminated further follow-up. Patients in the 12- and 24-month follow-up groups were older (p = 0.02; p < 0.01, respectively). Pain (VAS ≥ 3) was noticed in 22 % of the patients terminating follow-up before the 6-month survey and 41 % of the patients returning for the 24-month SMFA survey (χ2= 0.06). Improvements were found with time in SMFA subscores but arm and hand. No differences in SMFA subscores at 6 or 12 months were found between those leaving treatment untimely and those being released from office visits.
  
  
  CONCLUSIONS
  Follow-up remains important to obtain as much up-to-date information as possible. The current study does not support the assumption that patients lost to follow-up have a different SMFA outcome than patients returning until PRN.
  
  
  METHODS
  III.
authors.affiliation: BG-University Hospital Bergmannsheil, Buerkle-de-la-Camp-Platz 1, 44789, Bochum, Germany. MartinFHoffmann@gmx.net.
authors.forename: Martin F
authors.initials: MF
authors.lastname: Hoffmann
authors.affiliation: The Core Institute, Phoenix, AZ, USA.|Orthopaedic Associates of Michigan, Grand Rapids, MI, USA.
authors.forename: Debra L
authors.initials: DL
authors.lastname: Sietsema
authors.affiliation: The Core Institute, Phoenix, AZ, USA.|Orthopaedic Associates of Michigan, Grand Rapids, MI, USA.
authors.forename: Clifford B
authors.initials: CB
authors.lastname: Jones
mesh_terms: D000359:Aftercare / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000379:methods; D010147:Pain Measurement / Q000379:methods; D057240:Patient Preference / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000453:epidemiology / Q000601:surgery; D014481:United States / Q000453:epidemiology
keywords: Follow-up; Outcomes; SMFA; Tibial plateau fracture