Retrospective cohort study of 202 consecutive tibial plateau fractures treated with ORIF at a university hospital, with 109 patients receiving long-term follow-up (mean 14 years, range 5–27 years). Uses Neer score, HSS knee score, and Ahlbäck radiologic grading to determine which patient and fracture characteristics predict functional and radiologic outcomes over decades.
When fixing a tibial plateau fracture, restoring axial alignment is more critical than eliminating every millimeter of articular step-off — malalignment >5° triples the risk of significant post-traumatic arthritis, while residual step-off ≤4mm did not significantly alter outcomes in this cohort.
One-year ROM strongly predicts the long-term trajectory, making the first postoperative year a key window for rehabilitation optimization.
Retrospective cohort study of 202 consecutive tibial plateau fractures treated with ORIF at a university hospital, with 109 patients receiving long-term follow-up (mean 14 years, range 5–27 years). Uses Neer score, HSS knee score, and Ahlbäck radiologic grading to determine which patient and fracture characteristics predict functional and radiologic outcomes over decades.
When fixing a tibial plateau fracture, restoring axial alignment is more critical than eliminating every millimeter of articular step-off — malalignment >5° triples the risk of significant post-traumatic arthritis, while residual step-off ≤4mm did not significantly alter outcomes in this cohort.
One-year ROM strongly predicts the long-term trajectory, making the first postoperative year a key window for rehabilitation optimization.