Patient self-assessment of tibial plateau fractures in 40 older adults.

This retrospective study examined the outcome of 40 patients 50 or more years of age treated between September 1988 and September 1993 for tibial plateau fractures. Our analysis was based on a review of the medical records of all patients as well a patient self-assessment questionnaire. The 22 women and 18 men studied had a mean age of 60 (range, 50 to 76 years) at the time of injury. A satisfactory overall outcome (based on patients' self-assessment) was observed in only 14 (35%) of the 40 cases. Unsatisfactory outcomes were observed in 23 (72%) of 32 cases treated operatively and 3 (38%) of 8 cases treated nonoperatively. No significant difference in outcome was observed between the 27 patients with AO type B fractures and the 13 patients with AO type C fractures. Similarly, no significant difference in outcome was observed in patients with fractures involving the lateral plateau only, those with fractures involving the medial plateau only, and those with bicondylar fractures. There was no significant relationship between the adequacy of fracture reduction and overall clinical outcome, although a trend of more favorable outcomes was noted in patients with excellent or satisfactory reductions. The results suggest that patients of 50 or more years of age have a high rate of unsatisfactory clinical outcomes regardless of how their tibial plateau fractures are treated.