Relação entre os resultados funcionais, psicométricos e a redução da superfície articular obtidos após tratamento cirúrgico de fraturas do planalto tibial

Abstract

Introduction: tibial plateau fractures (TPF) are joint injuries that can lead to complications such as pain, angular deformities, joint instability, post-traumatic osteoarthritis and functional limitation. The objective of this study was to evaluate the function and quality of life of patients undergoing open reduction and internal fixation (ORIF) of tibial plateau fractures using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Society Score (KSS ) and Short Form 36 (SF-36) and their relationship with the quality of radiographic reduction of the fracture determined by the Rasmussen score. Methods: this is a retrospective cross-sectional study, in which 36 patients with tibial plateau fractures, treated surgically between 2010 and 2020, in a tertiary hospital were evaluated. The KSS and WOMAC were used to evaluate the functional outcome, the SF-36 was used for psychometric evaluation and the Rasmussen score to evaluate the quality of reduction. The mean age of the patients was 48.6 years and the mean follow-up time was 6.3 years. Results: there was a correlation between the Rasmussen score and WOMAC (p=0.005, R=0.45), with Rasmussen's condylar widening being the item that correlated with WOMAC (p=0.007, R0.43). The various divisions of the SF-36 questionnaire were correlated with the Rasmussen score. There was a correlation between the Rasmussen score and the KSS score (p=0.03; R=0.47). There was a correlation between the difference in range of motion (ROM) between the fractured side and the contralateral side and the Rasmussen score. Conclusion: the evaluation of the quality of reduction on postoperative radiographs using the Rasmussen score showed a statistically significant correlation with the WOMAC functional score, and the isolated component of the Rasmussen score that was related to the WOMAC was condylar widening. The SF-36 quality of life score and the KSS functional score also showed statistically significant correlations with the quality of reduction.