Objectives: To assess the outcome of patients with hyperextension bicondylar tibial plateau fractures (HEBTP) to those with other complex tibial plateau fractures

Design: Retrospective cohort design

Setting: Academic Medical Center

Patients: A total of 84 patients were included in the study. There were 69 patients with 69 knees (82%) that had sustained non-hyperextension bicondylar tibial plateau fractures and 15 patients with 15 knees (18%) that had hyperextension bicondylar tibial plateau fractures (HEBTP)

Intervention: Surgical repair of bicondylar tibial plateau fracture

Main Outcome Measures: Clinical and functional outcomes included knee range of motion, post-operative alignment, NRS pain scores and Short Musculoskeletal Functional Assessment (SMFA) scores at long-term follow-up. Complications were recorded for both cohorts including infection and post-traumatic osteoarthritis.

Results: There was no difference in knee range of motion at one-year follow-up between hyperextension and non-hypertension patients. Patients with hyperextension mechanisms did however have higher functional (SFMA) scores and a trend of higher pain scores, indicating worsened functional outcomes, and were more likely than their non-hyperextension mechanism counterparts to have associated soft tissue damage and to develop post-traumatic osteoarthritis.

Conclusions: Non-HEBTP and HEBTP fracture patients have similar outcomes in terms of range of motion at approximately 1 year of follow up, however, differ significantly in terms of functional recovery and the types of complications associated with their injuries.

Level of evidence: Prognostic Level III Study

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