Early recovery after surgically treated tibial plateau fractures varies by patient and injury characteristics: younger patients, particularly females under 50, reported worse pain and global physical health, while high-energy mechanisms were independently associated with poorer physical and psychological outcomes across multiple domains.
Key Findings
Results
Younger patients (under 50) reported worse pain interference and global physical health at 6 months after operative tibial plateau fracture fixation.
Patients < 50 reported higher pain interference scores compared to those ≥ 50 (62.7 vs. 59.3, p = 0.017)
Patients < 50 reported lower global physical health scores compared to those ≥ 50 (38.8 vs. 42.4, p = 0.023)
Study included 106 patients from a retrospective cohort at a Level I trauma center (2022-2024)
Mean age of the cohort was 50.4 years and 51.9% were male
Results
Among female patients, those under 50 years old had worse pain interference, global physical health, and anxiety scores at 6 months.
Females < 50 had higher pain interference scores compared to females ≥ 50 (64.0 vs. 58.5, p = 0.009)
Females < 50 had lower global physical health scores compared to females ≥ 50 (37.5 vs. 43.1, p = 0.011)
Females < 50 had lower anxiety scores compared to females ≥ 50 (60.2 vs. 64.1, p = 0.046)
Note: In PROMIS scoring, lower anxiety scores indicate worse anxiety symptoms in this context
Results
High-energy mechanism of injury was independently associated with worse outcomes across multiple physical and psychological PROMIS domains after adjustment.
High-energy injuries were associated with worse global physical health (p = 0.014) and global mental health (p = 0.011)
High-energy injuries were associated with worse depression (p = 0.009) and anxiety (p = 0.015) scores
High-energy injuries were associated with worse percent of normal function (p = 0.002) and brief resilience scale scores (p = 0.004)
These associations were identified after multivariable adjustment
Methods
Of 413 patients with operatively treated tibial plateau fractures identified, only 106 met inclusion criteria for the study.
Exclusion criteria included age < 18 years, non-operative or percutaneous fixation, and inadequate medical record documentation
The study was conducted at a Level I trauma center between 2022 and 2024
Primary outcomes were 6-month PROMIS scores including physical function, pain interference, global physical health, global mental health, anxiety/depression, brief resilience scale, and percent of normal function
Mean age was 50.4 years and 51.9% of included patients were male
Background
Tibial plateau fractures are complex injuries with high complication rates whose broader impact on patient-reported function and quality of life remains underexplored.
The study assessed the impact of demographics, fracture patterns, and treatment characteristics on PROMIS scores
Outcomes were compared by sex, age, mechanism of injury, fracture pattern, Schatzker type, and external fixation
The study design was a retrospective cohort study at a Level I trauma center