title: Quality of life and prognostic factors after intra-articular tibial pilon fracture.
abstract: BACKGROUND
  Intra-articular tibial plafond fractures are a challenge for the surgeon with generally poor functional outcomes. The purpose was to assess the impact of this injury on patient quality of life (QOL), as well as analyzed the predictor factors.
  
  
  METHODS
  Retrospective study of 47 patients with mean age of 44.4 (range 18-79) years. Patients were also invited for new clinical and radiological assessments. QOL was evaluated by the Short Form-36 questionnaire and compared to the standard in the age-matched general population. Olerud-Molander ankle score (OMAS) was used to assess function. Digital radiographs were evaluated for linear and angular measurements.
  
  
  RESULTS
  The mean follow-up at last visit was 5.3 (range, 2-10) years. Sequelae were present in 20 patients, mainly including chronic pain (8) and arthrosis (10). Articular step-off at least 2mm was present in 20 patients had, articular gap greater than 2mm in 13, and malalignment in 5. Worse reduction was obtained with external fixation. QOL was significant lower than age-matched general population (p=0.000). Main prognostic factors of worse SF36 were fracture severity, reduction quality and arthrosis. A strong significant relationship was found between SF36-physical and OMAS scores (p=0.000).
  
  
  CONCLUSIONS
  Intra-articular tibial plafond fracture had a dramatic impact on QOL. Among the predictors of unsuccessful outcome, the reduction quality was the only modifiable factor by the surgeon. The OMAS had a predictive value on the prognosis of QOL.
authors.affiliation: Department of Ortopaedics and Trauma, Reina Sofia University Hospital, Murcia, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: De-Las-Heras-Romero
authors.affiliation: Department of Ortopaedics and Trauma, Reina Sofia University Hospital, Murcia, Spain.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Lledo-Alvarez
authors.affiliation: Orthopaedia and Traumatology, Faculty of Medicine, Miguel Hernandez University, Elche, Alicante, Spain. Electronic address: lizaur1@telefonica.net.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Lizaur-Utrilla
authors.affiliation: Orthopaedia and Traumatology, Faculty of Medicine, Miguel Hernandez University, Elche, Alicante, Spain.
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Lopez-Prats
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000502:physiology*; D001860:Bone Plates; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000592:standards; D018460:Fractures, Comminuted / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology*; D011379:Prognosis; D011788:Quality of Life; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
keywords: Functional outcome; Pilon fracture; Quality of life; Tibial plafond fracture