| Abstract [eng] |
The objective of this study was to evaluate the association of modifiable risk variables and postoperative complications after surgical treatment of tibial plateau fractures. A case-control study was conducted in the Republican Vilnius University Hospital. Controls and cases were similar on age (> 18 years) and fracture type of IV – VI in the Schatzker classification. A total of 181 cases (30 with complications and 151 without) were collected over a period of 4 years. Statistical comparisons were evaluated using the Fisher-Test for categorical variables and Kruskal-Wallis-Test for continuous variables. Odds of surgery related complications were estimated from multivariable logistic regression, with adjustment for the three Schatzker classifications, incorporating significant variables and such with a tendency towards significancy. The use of external fixation (OR= 0.571, 95% CI: 0.051 – 3.904, p=0.601), the number of incisions (Odds Ratio = 0.372, 95% Confidence Interval: 0.063 – 2.198, p=0.272) and the length of hospital stays (Odds Ratio = 1.056, 95% Confidence Interval: 0.959 – 1.159, p=0.252) were not significantly associated with the rate of complications. The Schatzker classification type VI was associated with an increased risk of complications among the subjects. However, this variable is considered a trauma related complication and is therefore not modifiable. A statistically significant association however was observed between the modifiable variable of operation duration and the increased odds of postoperative complications (Odds Ratio = 1.013, 95% Confidence Interval: 1.001 – 1.025, p=0.035). Surgeries should therefore be conducted as quickly as possible while maintaining good quality. Surgeons should be cognisant of this risk and should create a good, well thought-out, and individual operation strategy for each patient. |
