Proximal Tibial Metaphyseal Fractures with Severe Soft Tissue Injury: Clinical and Functional Results at 2 Years

Background Controversy exists regarding management of proximal tibial metaphyseal fractures with severe soft tissue injury. It is unclear whether limb salvage or early amputation results in the best functional and clinical outcomes. Questions/Purpose We hypothesized that in this group of patients, t...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Starman, James S. [verfasserIn] Castillo, Renan C. [verfasserIn] Bosse, Michael J. [verfasserIn] MacKenzie, Ellen J. [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2009

Schlagwörter:	External Fixation Plate Fixation Limb Salvage Soft Tissue Injury Soft Tissue Coverage

Übergeordnetes Werk:	Enthalten in: Clinical orthopaedics and related research - Philadelphia, PA : Wolters Kluwer Health, 1963, 468(2009), 6 vom: 28. Okt., Seite 1669-1675
Übergeordnetes Werk:	volume:468 ; year:2009 ; number:6 ; day:28 ; month:10 ; pages:1669-1675

Links:	Volltext

DOI / URN:	10.1007/s11999-009-1148-4

Katalog-ID:	SPR023575255

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520			\|a Background Controversy exists regarding management of proximal tibial metaphyseal fractures with severe soft tissue injury. It is unclear whether limb salvage or early amputation results in the best functional and clinical outcomes. Questions/Purpose We hypothesized that in this group of patients, there is no difference in functional outcomes, complication rates, clinical outcomes, or objective physical function related to the treatment approach. Methods We used the LEAP study database to perform a retrospective comparative review of a subset of patients with proximal tibial metaphyseal fractures (AO/OTA 41A, B, and C) with associated severe soft tissue injuries comparing the outcomes of patients who were treated with either limb salvage or amputation. Results Although there were major differences in clinical and functional outcomes based on patients’ sociodemographics at 2 years, no differences in clinical or functional outcomes were detected regardless of whether amputation or limb salvage was performed. Severity of soft tissue injury was more predictive of outcome than the surgical approach used. Conclusions Sociodemographics and soft tissue injury severity are more important than treatment approach for predicting clinical and functional outcomes at 2 years in patients with proximal tibia metaphyseal fractures with severe soft tissue injury. Level of Evidence Level III, retrospective comparative study. See Guidelines for Authors for a complete description of levels of evidence.
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allfields	10.1007/s11999-009-1148-4 doi (DE-627)SPR023575255 (SPR)s11999-009-1148-4-e DE-627 ger DE-627 rakwb eng 610 ASE 44.83 bkl Starman, James S. verfasserin aut Proximal Tibial Metaphyseal Fractures with Severe Soft Tissue Injury: Clinical and Functional Results at 2 Years 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Controversy exists regarding management of proximal tibial metaphyseal fractures with severe soft tissue injury. It is unclear whether limb salvage or early amputation results in the best functional and clinical outcomes. Questions/Purpose We hypothesized that in this group of patients, there is no difference in functional outcomes, complication rates, clinical outcomes, or objective physical function related to the treatment approach. Methods We used the LEAP study database to perform a retrospective comparative review of a subset of patients with proximal tibial metaphyseal fractures (AO/OTA 41A, B, and C) with associated severe soft tissue injuries comparing the outcomes of patients who were treated with either limb salvage or amputation. Results Although there were major differences in clinical and functional outcomes based on patients’ sociodemographics at 2 years, no differences in clinical or functional outcomes were detected regardless of whether amputation or limb salvage was performed. Severity of soft tissue injury was more predictive of outcome than the surgical approach used. Conclusions Sociodemographics and soft tissue injury severity are more important than treatment approach for predicting clinical and functional outcomes at 2 years in patients with proximal tibia metaphyseal fractures with severe soft tissue injury. Level of Evidence Level III, retrospective comparative study. See Guidelines for Authors for a complete description of levels of evidence. External Fixation (dpeaa)DE-He213 Plate Fixation (dpeaa)DE-He213 Limb Salvage (dpeaa)DE-He213 Soft Tissue Injury (dpeaa)DE-He213 Soft Tissue Coverage (dpeaa)DE-He213 Castillo, Renan C. verfasserin aut Bosse, Michael J. verfasserin aut MacKenzie, Ellen J. verfasserin aut Enthalten in Clinical orthopaedics and related research Philadelphia, PA : Wolters Kluwer Health, 1963 468(2009), 6 vom: 28. Okt., Seite 1669-1675 (DE-627)316019062 (DE-600)2018318-5 1528-1132 nnns volume:468 year:2009 number:6 day:28 month:10 pages:1669-1675 https://dx.doi.org/10.1007/s11999-009-1148-4 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.83 ASE AR 468 2009 6 28 10 1669-1675
spelling	10.1007/s11999-009-1148-4 doi (DE-627)SPR023575255 (SPR)s11999-009-1148-4-e DE-627 ger DE-627 rakwb eng 610 ASE 44.83 bkl Starman, James S. verfasserin aut Proximal Tibial Metaphyseal Fractures with Severe Soft Tissue Injury: Clinical and Functional Results at 2 Years 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Controversy exists regarding management of proximal tibial metaphyseal fractures with severe soft tissue injury. It is unclear whether limb salvage or early amputation results in the best functional and clinical outcomes. Questions/Purpose We hypothesized that in this group of patients, there is no difference in functional outcomes, complication rates, clinical outcomes, or objective physical function related to the treatment approach. Methods We used the LEAP study database to perform a retrospective comparative review of a subset of patients with proximal tibial metaphyseal fractures (AO/OTA 41A, B, and C) with associated severe soft tissue injuries comparing the outcomes of patients who were treated with either limb salvage or amputation. Results Although there were major differences in clinical and functional outcomes based on patients’ sociodemographics at 2 years, no differences in clinical or functional outcomes were detected regardless of whether amputation or limb salvage was performed. Severity of soft tissue injury was more predictive of outcome than the surgical approach used. Conclusions Sociodemographics and soft tissue injury severity are more important than treatment approach for predicting clinical and functional outcomes at 2 years in patients with proximal tibia metaphyseal fractures with severe soft tissue injury. Level of Evidence Level III, retrospective comparative study. See Guidelines for Authors for a complete description of levels of evidence. External Fixation (dpeaa)DE-He213 Plate Fixation (dpeaa)DE-He213 Limb Salvage (dpeaa)DE-He213 Soft Tissue Injury (dpeaa)DE-He213 Soft Tissue Coverage (dpeaa)DE-He213 Castillo, Renan C. verfasserin aut Bosse, Michael J. verfasserin aut MacKenzie, Ellen J. verfasserin aut Enthalten in Clinical orthopaedics and related research Philadelphia, PA : Wolters Kluwer Health, 1963 468(2009), 6 vom: 28. Okt., Seite 1669-1675 (DE-627)316019062 (DE-600)2018318-5 1528-1132 nnns volume:468 year:2009 number:6 day:28 month:10 pages:1669-1675 https://dx.doi.org/10.1007/s11999-009-1148-4 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.83 ASE AR 468 2009 6 28 10 1669-1675
allfields_unstemmed	10.1007/s11999-009-1148-4 doi (DE-627)SPR023575255 (SPR)s11999-009-1148-4-e DE-627 ger DE-627 rakwb eng 610 ASE 44.83 bkl Starman, James S. verfasserin aut Proximal Tibial Metaphyseal Fractures with Severe Soft Tissue Injury: Clinical and Functional Results at 2 Years 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Controversy exists regarding management of proximal tibial metaphyseal fractures with severe soft tissue injury. It is unclear whether limb salvage or early amputation results in the best functional and clinical outcomes. Questions/Purpose We hypothesized that in this group of patients, there is no difference in functional outcomes, complication rates, clinical outcomes, or objective physical function related to the treatment approach. Methods We used the LEAP study database to perform a retrospective comparative review of a subset of patients with proximal tibial metaphyseal fractures (AO/OTA 41A, B, and C) with associated severe soft tissue injuries comparing the outcomes of patients who were treated with either limb salvage or amputation. Results Although there were major differences in clinical and functional outcomes based on patients’ sociodemographics at 2 years, no differences in clinical or functional outcomes were detected regardless of whether amputation or limb salvage was performed. Severity of soft tissue injury was more predictive of outcome than the surgical approach used. Conclusions Sociodemographics and soft tissue injury severity are more important than treatment approach for predicting clinical and functional outcomes at 2 years in patients with proximal tibia metaphyseal fractures with severe soft tissue injury. Level of Evidence Level III, retrospective comparative study. See Guidelines for Authors for a complete description of levels of evidence. External Fixation (dpeaa)DE-He213 Plate Fixation (dpeaa)DE-He213 Limb Salvage (dpeaa)DE-He213 Soft Tissue Injury (dpeaa)DE-He213 Soft Tissue Coverage (dpeaa)DE-He213 Castillo, Renan C. verfasserin aut Bosse, Michael J. verfasserin aut MacKenzie, Ellen J. verfasserin aut Enthalten in Clinical orthopaedics and related research Philadelphia, PA : Wolters Kluwer Health, 1963 468(2009), 6 vom: 28. Okt., Seite 1669-1675 (DE-627)316019062 (DE-600)2018318-5 1528-1132 nnns volume:468 year:2009 number:6 day:28 month:10 pages:1669-1675 https://dx.doi.org/10.1007/s11999-009-1148-4 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.83 ASE AR 468 2009 6 28 10 1669-1675
allfieldsGer	10.1007/s11999-009-1148-4 doi (DE-627)SPR023575255 (SPR)s11999-009-1148-4-e DE-627 ger DE-627 rakwb eng 610 ASE 44.83 bkl Starman, James S. verfasserin aut Proximal Tibial Metaphyseal Fractures with Severe Soft Tissue Injury: Clinical and Functional Results at 2 Years 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Controversy exists regarding management of proximal tibial metaphyseal fractures with severe soft tissue injury. It is unclear whether limb salvage or early amputation results in the best functional and clinical outcomes. Questions/Purpose We hypothesized that in this group of patients, there is no difference in functional outcomes, complication rates, clinical outcomes, or objective physical function related to the treatment approach. Methods We used the LEAP study database to perform a retrospective comparative review of a subset of patients with proximal tibial metaphyseal fractures (AO/OTA 41A, B, and C) with associated severe soft tissue injuries comparing the outcomes of patients who were treated with either limb salvage or amputation. Results Although there were major differences in clinical and functional outcomes based on patients’ sociodemographics at 2 years, no differences in clinical or functional outcomes were detected regardless of whether amputation or limb salvage was performed. Severity of soft tissue injury was more predictive of outcome than the surgical approach used. Conclusions Sociodemographics and soft tissue injury severity are more important than treatment approach for predicting clinical and functional outcomes at 2 years in patients with proximal tibia metaphyseal fractures with severe soft tissue injury. Level of Evidence Level III, retrospective comparative study. See Guidelines for Authors for a complete description of levels of evidence. External Fixation (dpeaa)DE-He213 Plate Fixation (dpeaa)DE-He213 Limb Salvage (dpeaa)DE-He213 Soft Tissue Injury (dpeaa)DE-He213 Soft Tissue Coverage (dpeaa)DE-He213 Castillo, Renan C. verfasserin aut Bosse, Michael J. verfasserin aut MacKenzie, Ellen J. verfasserin aut Enthalten in Clinical orthopaedics and related research Philadelphia, PA : Wolters Kluwer Health, 1963 468(2009), 6 vom: 28. Okt., Seite 1669-1675 (DE-627)316019062 (DE-600)2018318-5 1528-1132 nnns volume:468 year:2009 number:6 day:28 month:10 pages:1669-1675 https://dx.doi.org/10.1007/s11999-009-1148-4 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.83 ASE AR 468 2009 6 28 10 1669-1675
allfieldsSound	10.1007/s11999-009-1148-4 doi (DE-627)SPR023575255 (SPR)s11999-009-1148-4-e DE-627 ger DE-627 rakwb eng 610 ASE 44.83 bkl Starman, James S. verfasserin aut Proximal Tibial Metaphyseal Fractures with Severe Soft Tissue Injury: Clinical and Functional Results at 2 Years 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Controversy exists regarding management of proximal tibial metaphyseal fractures with severe soft tissue injury. It is unclear whether limb salvage or early amputation results in the best functional and clinical outcomes. Questions/Purpose We hypothesized that in this group of patients, there is no difference in functional outcomes, complication rates, clinical outcomes, or objective physical function related to the treatment approach. Methods We used the LEAP study database to perform a retrospective comparative review of a subset of patients with proximal tibial metaphyseal fractures (AO/OTA 41A, B, and C) with associated severe soft tissue injuries comparing the outcomes of patients who were treated with either limb salvage or amputation. Results Although there were major differences in clinical and functional outcomes based on patients’ sociodemographics at 2 years, no differences in clinical or functional outcomes were detected regardless of whether amputation or limb salvage was performed. Severity of soft tissue injury was more predictive of outcome than the surgical approach used. Conclusions Sociodemographics and soft tissue injury severity are more important than treatment approach for predicting clinical and functional outcomes at 2 years in patients with proximal tibia metaphyseal fractures with severe soft tissue injury. Level of Evidence Level III, retrospective comparative study. See Guidelines for Authors for a complete description of levels of evidence. External Fixation (dpeaa)DE-He213 Plate Fixation (dpeaa)DE-He213 Limb Salvage (dpeaa)DE-He213 Soft Tissue Injury (dpeaa)DE-He213 Soft Tissue Coverage (dpeaa)DE-He213 Castillo, Renan C. verfasserin aut Bosse, Michael J. verfasserin aut MacKenzie, Ellen J. verfasserin aut Enthalten in Clinical orthopaedics and related research Philadelphia, PA : Wolters Kluwer Health, 1963 468(2009), 6 vom: 28. Okt., Seite 1669-1675 (DE-627)316019062 (DE-600)2018318-5 1528-1132 nnns volume:468 year:2009 number:6 day:28 month:10 pages:1669-1675 https://dx.doi.org/10.1007/s11999-009-1148-4 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.83 ASE AR 468 2009 6 28 10 1669-1675
language	English
source	Enthalten in Clinical orthopaedics and related research 468(2009), 6 vom: 28. Okt., Seite 1669-1675 volume:468 year:2009 number:6 day:28 month:10 pages:1669-1675
sourceStr	Enthalten in Clinical orthopaedics and related research 468(2009), 6 vom: 28. Okt., Seite 1669-1675 volume:468 year:2009 number:6 day:28 month:10 pages:1669-1675
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	External Fixation Plate Fixation Limb Salvage Soft Tissue Injury Soft Tissue Coverage
dewey-raw	610
isfreeaccess_bool	false
container_title	Clinical orthopaedics and related research
authorswithroles_txt_mv	Starman, James S. @@aut@@ Castillo, Renan C. @@aut@@ Bosse, Michael J. @@aut@@ MacKenzie, Ellen J. @@aut@@
publishDateDaySort_date	2009-10-28T00:00:00Z
hierarchy_top_id	316019062
dewey-sort	3610
id	SPR023575255
language_de	englisch
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It is unclear whether limb salvage or early amputation results in the best functional and clinical outcomes. Questions/Purpose We hypothesized that in this group of patients, there is no difference in functional outcomes, complication rates, clinical outcomes, or objective physical function related to the treatment approach. Methods We used the LEAP study database to perform a retrospective comparative review of a subset of patients with proximal tibial metaphyseal fractures (AO/OTA 41A, B, and C) with associated severe soft tissue injuries comparing the outcomes of patients who were treated with either limb salvage or amputation. Results Although there were major differences in clinical and functional outcomes based on patients’ sociodemographics at 2 years, no differences in clinical or functional outcomes were detected regardless of whether amputation or limb salvage was performed. Severity of soft tissue injury was more predictive of outcome than the surgical approach used. Conclusions Sociodemographics and soft tissue injury severity are more important than treatment approach for predicting clinical and functional outcomes at 2 years in patients with proximal tibia metaphyseal fractures with severe soft tissue injury. Level of Evidence Level III, retrospective comparative study. 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author	Starman, James S.
spellingShingle	Starman, James S. ddc 610 bkl 44.83 misc External Fixation misc Plate Fixation misc Limb Salvage misc Soft Tissue Injury misc Soft Tissue Coverage Proximal Tibial Metaphyseal Fractures with Severe Soft Tissue Injury: Clinical and Functional Results at 2 Years
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topic_title	610 ASE 44.83 bkl Proximal Tibial Metaphyseal Fractures with Severe Soft Tissue Injury: Clinical and Functional Results at 2 Years External Fixation (dpeaa)DE-He213 Plate Fixation (dpeaa)DE-He213 Limb Salvage (dpeaa)DE-He213 Soft Tissue Injury (dpeaa)DE-He213 Soft Tissue Coverage (dpeaa)DE-He213
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title	Proximal Tibial Metaphyseal Fractures with Severe Soft Tissue Injury: Clinical and Functional Results at 2 Years
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title_full	Proximal Tibial Metaphyseal Fractures with Severe Soft Tissue Injury: Clinical and Functional Results at 2 Years
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author_browse	Starman, James S. Castillo, Renan C. Bosse, Michael J. MacKenzie, Ellen J.
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title_sort	proximal tibial metaphyseal fractures with severe soft tissue injury: clinical and functional results at 2 years
title_auth	Proximal Tibial Metaphyseal Fractures with Severe Soft Tissue Injury: Clinical and Functional Results at 2 Years
abstract	Background Controversy exists regarding management of proximal tibial metaphyseal fractures with severe soft tissue injury. It is unclear whether limb salvage or early amputation results in the best functional and clinical outcomes. Questions/Purpose We hypothesized that in this group of patients, there is no difference in functional outcomes, complication rates, clinical outcomes, or objective physical function related to the treatment approach. Methods We used the LEAP study database to perform a retrospective comparative review of a subset of patients with proximal tibial metaphyseal fractures (AO/OTA 41A, B, and C) with associated severe soft tissue injuries comparing the outcomes of patients who were treated with either limb salvage or amputation. Results Although there were major differences in clinical and functional outcomes based on patients’ sociodemographics at 2 years, no differences in clinical or functional outcomes were detected regardless of whether amputation or limb salvage was performed. Severity of soft tissue injury was more predictive of outcome than the surgical approach used. Conclusions Sociodemographics and soft tissue injury severity are more important than treatment approach for predicting clinical and functional outcomes at 2 years in patients with proximal tibia metaphyseal fractures with severe soft tissue injury. Level of Evidence Level III, retrospective comparative study. See Guidelines for Authors for a complete description of levels of evidence.
abstractGer	Background Controversy exists regarding management of proximal tibial metaphyseal fractures with severe soft tissue injury. It is unclear whether limb salvage or early amputation results in the best functional and clinical outcomes. Questions/Purpose We hypothesized that in this group of patients, there is no difference in functional outcomes, complication rates, clinical outcomes, or objective physical function related to the treatment approach. Methods We used the LEAP study database to perform a retrospective comparative review of a subset of patients with proximal tibial metaphyseal fractures (AO/OTA 41A, B, and C) with associated severe soft tissue injuries comparing the outcomes of patients who were treated with either limb salvage or amputation. Results Although there were major differences in clinical and functional outcomes based on patients’ sociodemographics at 2 years, no differences in clinical or functional outcomes were detected regardless of whether amputation or limb salvage was performed. Severity of soft tissue injury was more predictive of outcome than the surgical approach used. Conclusions Sociodemographics and soft tissue injury severity are more important than treatment approach for predicting clinical and functional outcomes at 2 years in patients with proximal tibia metaphyseal fractures with severe soft tissue injury. Level of Evidence Level III, retrospective comparative study. See Guidelines for Authors for a complete description of levels of evidence.
abstract_unstemmed	Background Controversy exists regarding management of proximal tibial metaphyseal fractures with severe soft tissue injury. It is unclear whether limb salvage or early amputation results in the best functional and clinical outcomes. Questions/Purpose We hypothesized that in this group of patients, there is no difference in functional outcomes, complication rates, clinical outcomes, or objective physical function related to the treatment approach. Methods We used the LEAP study database to perform a retrospective comparative review of a subset of patients with proximal tibial metaphyseal fractures (AO/OTA 41A, B, and C) with associated severe soft tissue injuries comparing the outcomes of patients who were treated with either limb salvage or amputation. Results Although there were major differences in clinical and functional outcomes based on patients’ sociodemographics at 2 years, no differences in clinical or functional outcomes were detected regardless of whether amputation or limb salvage was performed. Severity of soft tissue injury was more predictive of outcome than the surgical approach used. Conclusions Sociodemographics and soft tissue injury severity are more important than treatment approach for predicting clinical and functional outcomes at 2 years in patients with proximal tibia metaphyseal fractures with severe soft tissue injury. Level of Evidence Level III, retrospective comparative study. See Guidelines for Authors for a complete description of levels of evidence.
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title_short	Proximal Tibial Metaphyseal Fractures with Severe Soft Tissue Injury: Clinical and Functional Results at 2 Years
url	https://dx.doi.org/10.1007/s11999-009-1148-4
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up_date	2024-07-03T19:49:02.114Z
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fullrecord_marcxml	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR023575255</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230519072936.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">201006s2009 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1007/s11999-009-1148-4</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR023575255</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s11999-009-1148-4-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">ASE</subfield></datafield><datafield tag="084" ind1=" " ind2=" "><subfield code="a">44.83</subfield><subfield code="2">bkl</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Starman, James S.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Proximal Tibial Metaphyseal Fractures with Severe Soft Tissue Injury: Clinical and Functional Results at 2 Years</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2009</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background Controversy exists regarding management of proximal tibial metaphyseal fractures with severe soft tissue injury. It is unclear whether limb salvage or early amputation results in the best functional and clinical outcomes. Questions/Purpose We hypothesized that in this group of patients, there is no difference in functional outcomes, complication rates, clinical outcomes, or objective physical function related to the treatment approach. Methods We used the LEAP study database to perform a retrospective comparative review of a subset of patients with proximal tibial metaphyseal fractures (AO/OTA 41A, B, and C) with associated severe soft tissue injuries comparing the outcomes of patients who were treated with either limb salvage or amputation. Results Although there were major differences in clinical and functional outcomes based on patients’ sociodemographics at 2 years, no differences in clinical or functional outcomes were detected regardless of whether amputation or limb salvage was performed. Severity of soft tissue injury was more predictive of outcome than the surgical approach used. Conclusions Sociodemographics and soft tissue injury severity are more important than treatment approach for predicting clinical and functional outcomes at 2 years in patients with proximal tibia metaphyseal fractures with severe soft tissue injury. Level of Evidence Level III, retrospective comparative study. 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Proximal Tibial Metaphyseal Fractures with Severe Soft Tissue Injury: Clinical and Functional Results at 2 Years

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