Clinical and Patient reported outcomes following open reduction and internal fixation for distal tibial intra-articular fractures

Abstract

IntroductionIntra-articular distal tibial plafond fractures are rare injuries, provide a challenge for the surgeon and can often have poor outcomes. The aim of this paper was to report long term patient reported functional outcomes, health related quality of life (QoL) scores and rates of complications in order to fully counsel the patient on likely outcomes and set realistic post-operative expectations for the patient. MethodsWe conducted a retrospective review of 20 patients with distal tibial intra-articular fractures that presented to our institution between September 2014 and September 2020. All patients underwent open reduction and internal fixation (ORIF). Clinical, radiological and patient reported outcome measures (PROMS), quality of life (QoL) scores and complications were collected. ResultsThe mean age of the patients at the time of surgery was 50.6 years (24−71). There were 7 males and 13 females. There were 4 open and 16 closed fractures. There were 7 Rüedi and Allgöwer (RA) Type 1, 9 Type 2 and 4 Type 3 fractures. The mean follow-up was 3.8 years [1–7]. The mean OMAS score was 54.3, reaching a peak at 2 years from injury. The mean QoL score (EQ5D5L) was 0.602, representing only 70 % of aged matched, UK population based norms. ConclusionsWhilst clinical outcomes are comparable with other studies, this report highlights this is a devastating injury, with most people taking 2 years to reach peak recovery. QoL outcome scores only reach 70 % normal and only 35 % of patients return to within 10 % of age matched population based norms.