title: Functional and Clinical Outcomes of Nonsurgically Managed Tibial Plateau Fractures.
abstract: BACKGROUND
  This study sought to assess and compare long-term functional and clinical outcomes in patients with tibial plateau fractures that are treated nonsurgically.
  
  
  METHODS
  Over a period of 8 years, 305 consecutive tibial plateau fractures were treated by three surgeons at a single institution and followed prospectively in an Institutional Review Board-approved study. Overall, 41 patients (13%) were treated nonsurgically and 37 were available for follow-up. Indications for nonsurgical management were minimal fracture displacement or preclusion of surgery because of comorbidities. A series of univariate retrospective analyses were used to identify individual risk factors potentially predictive of Short Musculoskeletal Functional Assessment scores.
  
  
  RESULTS
  Thirty-seven patients were included with a mean follow-up of 21 ± 14.9 months. Overall, 59% of patients (n = 22) attained good to excellent functional outcomes. In patients for whom surgery was precluded because of comorbidities, outcome scores were significantly poorer (38.8 ± 23.0 versus 12.7 ± 14.2; P = 0.001). Surgery precluded by a factor other than minimal fracture displacement predicted poor outcome (P = 0.002).
  
  
  CONCLUSIONS
  Carefully selected patients with minimally displaced tibial plateau fractures can expect good to excellent outcomes when treated nonsurgically.
  
  
  METHODS
  Level III, retrospective comparative study.
authors.affiliation: From the Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY.
authors.forename: Christian A
authors.initials: CA
authors.lastname: Pean
authors.forename: Adam
authors.initials: A
authors.lastname: Driesman
authors.forename: Anthony
authors.initials: A
authors.lastname: Christiano
authors.forename: Sanjit R
authors.initials: SR
authors.lastname: Konda
authors.forename: Roy
authors.initials: R
authors.lastname: Davidovitch
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Egol
mesh_terms: D000704:Analysis of Variance; D005500:Follow-Up Studies; D006801:Humans; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000628:therapy*; D016896:Treatment Outcome