Abstract:
Introduction: Tibial plateau fractures (TPF) are high-energy fractures that often require surgery for proper healing. Literature identifies high body mass index (BMI) as a risk factor for poor surgical outcomes. This study aims to better understand how BMI affects outcomes after TPF surgery, comparing groups of patients with BMI < 25, 25-35, and > 35. We hypothesized that patients with BMI < 25 would have fewer complications and shorter time to weightbearing compared to patients with BMI 25-35 and BMI > 35.
Methods: The study retrospectively collected patient data through one institutions’ electronic medical records for patients who had billing codes for TPF surgery between March 2016 and April 2025. Variables collected included patient demographics, surgical methods, complications, time to weight bearing, and other outcome metrics. Inclusion criteria were adult patients who underwent surgery for repair of TPF sustained from a trauma mechanism. Exclusion criteria were pediatric patients, patients who received solely subchondroplasty surgery, and patients who suffered a fracture due to malignancy. 418 patients were initially analyzed, and excluding 170 based on these criteria led to 248 total included patients. Data were analyzed using SPSS.
Results: Rates of reoperation were significantly highest in the population with BMI 25-35 as compared to the groups of patients with BMI < 25 and > 35. Rates of hardware removal were also significantly highest in the population with BMI 25-35 as compared to the groups of patients with BMI < 25 and > 35. There was no significant difference between the three groups for time to weightbearing, total complication rates, or length of stay.
Conclusion: Understanding factors that affect surgical outcomes is imperative for prevention of complications and allowing patients to make informed decisions regarding their care. With the data demonstrating a lack of significant increases in major complications or time to recovery, it is crucial to advocate for patients with increased BMI to pursue surgery that could greatly improve their long-term quality of life.
