{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:36:59Z","timestamp":1789580219093,"version":"build-2803163510"},"reference-count":38,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Tibial plateau fractures (TPFs) are complex injuries often leading to long-term complications such as knee instability, limited range of motion, and osteoarthritis. Accurate diagnostic evaluations combining subjective and objective assessments are essential for identifying functional limitations, guiding rehabilitation, and improving recovery outcomes. This study examines the role of diagnostic predictors in differentiating recovery trajectories in two groups of patients treated for closed TPFs by open reduction and internal fixation (ORIF), comparing patients with less severe fractures and patients with more severe fractures (BCFs). Methods: A consecutive series of patients with a diagnosis of TPFs treated by ORIF at our institution between 2009 and 2016 were analyzed in this retrospective study. All injured patients were divided according to the Schatzker classification into two groups: mono-condylar (MCF) and bi-condylar (BCF) fracture patient groups. Diagnostic evaluations included patient-reported outcome measures (PROMs) such as KOOS, IKDC, and AKSS, alongside objective assessments of functional recovery using dynamometers, force platform tests (single-leg stance and squat jump variations), and measurements of active range of motion (AROM). Results: A total of 28 patients were included: 17 in the MCF patient group (Schatzker: 12 II; 5 III; 0 IV) and 11 in the BCF patient group (Schatzker: 6 V; 5 VI). Patients with less severe MCFs exhibited significantly better recovery outcomes, including higher KOOS (86.0 vs. 64.6, p = 0.04), IKDC (80.3 vs. 64.6, p = 0.04), and AKSS (95.3 vs. 70.5, p = 0.02) scores. They also demonstrated greater knee flexion (122.8\u00b0 vs. 105.5\u00b0, p = 0.04) and faster neuromuscular recovery, as evidenced by higher rates of force development (RFD) during dynamic performance tests. Conversely, patients with more severe BCFs showed lower RFD values, indicating slower recovery and greater rehabilitation challenges. Conclusions: Integrating diagnostic tools like PROMs, AROM, and neuromuscular performance tests provides valuable insights into recovery after ORIF for TPFs. Fracture severity significantly impacts functional recovery patients with MCFs showing better outcomes and faster neuromuscular recovery, while subjects with BCFs require a longer rehabilitation treatment focusing on neuromuscular re-education and soft tissue recovery.<\/jats:p>","DOI":"10.3390\/diagnostics15111304","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T04:32:37Z","timestamp":1747888357000},"page":"1304","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Diagnostic Predictors of Recovery Outcomes Following Open Reduction and Internal Fixation for Tibial Plateau Fractures: A Retrospective Study Based on the Schatzker Classification"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8517-0057","authenticated-orcid":false,"given":"Carlo","family":"Biz","sequence":"first","affiliation":[{"name":"Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padova, Via N. Giustiniani 3, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8767-4555","authenticated-orcid":false,"given":"Carla","family":"Stecco","sequence":"additional","affiliation":[{"name":"Institute of Human Anatomy, Department of Neurosciences, University of Padova, Via A. Gabelli 65, 35121 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuele","family":"Perissinotto","sequence":"additional","affiliation":[{"name":"Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padova, Via N. Giustiniani 3, 35128 Padova, Italy"},{"name":"Department of Neurosciences, University of Padova, Via G. Belzoni 160, 35121 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1237-3689","authenticated-orcid":false,"given":"Xiaoxiao","family":"Zhao","sequence":"additional","affiliation":[{"name":"Institute of Human Anatomy, Department of Neurosciences, University of Padova, Via A. Gabelli 65, 35121 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Ierardi","sequence":"additional","affiliation":[{"name":"Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padova, Via N. Giustiniani 3, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0825-2707","authenticated-orcid":false,"given":"Luca","family":"Puce","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7220-1221","authenticated-orcid":false,"given":"Filippo","family":"Migliorini","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Via Lorenz B\u00f6hler 5, 39100 Bolzano, Italy"},{"name":"Department of Life Sciences, Health, and Health Professions, Link Campus University, Via del Casale di San Pio V, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8409-868X","authenticated-orcid":false,"given":"Nicola Luigi","family":"Bragazzi","sequence":"additional","affiliation":[{"name":"Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9617-9882","authenticated-orcid":false,"given":"Pietro","family":"Ruggieri","sequence":"additional","affiliation":[{"name":"Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padova, Via N. Giustiniani 3, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1111\/os.12577","article-title":"Challenging Surgical Treatment of Displaced Articular Tibial Plateau Fractures: Do Early Knee Radiographic Features Have a Predictive Value of the Mid-Term Clinical Functional Outcomes?","volume":"11","author":"Biz","year":"2019","journal-title":"Orthop. Surg."},{"key":"ref_2","first-page":"404","article-title":"Weight Discharge in Postoperative of Plateau Fracture Tibialis: Systematic Review of Literature","volume":"55","author":"Alves","year":"2020","journal-title":"Rev. Bras. 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