• OBJECTIVES
    • To assess the outcome of patients with hyperextension bicondylar tibial plateau fractures (HEBTPs) and 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-HEBTPs and 15 patients with 15 knees (18%) that had HEBTPs.
  • INTERVENTION
    • Surgical repair of bicondylar tibial plateau fracture.
  • MAIN OUTCOME MEASURES
    • Clinical and functional outcomes included knee range of motion, postoperative alignment, numerical rating scale pain scores, and Short Musculoskeletal Functional Assessment (SMFA) scores at long-term follow-up. Complications were recorded for both cohorts including infection and posttraumatic osteoarthritis.
  • RESULTS
    • There was no difference in knee range of motion at 1-year follow-up between hyperextension and nonhypertension patients. Patients with hyperextension mechanisms did however have higher functional (SMFA) scores and a trend of higher pain scores, indicating worsened functional outcomes and were more likely than their nonhyperextension mechanism counterparts to have associated soft-tissue damage and to develop posttraumatic 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. See Instructions for Authors for a complete description of levels of evidence.