Tibial plateau fractures are associated with a long-term increased risk of mortality: a matched cohort study of 7950 patients

Introduction: Disregarding proximal femoral fractures, the current literature includes only limited information regarding mortality following lower extremity fractures. Information regarding risk of mortality related to specific fracture patterns is essential when planning treatment modalities. The primary aim of this study was to report the long-term cumulative survival rate in patients with a tibial plateau fracture compared to an age- and gender-matched reference population. Materials and methods: Patients who sustained a tibial plateau fracture in Denmark between 1996 and 2000 were included in the study. Survival status was monitored until 2015. We compared the mortality rate with a tenfold reference population matched on age and gender without a prior tibial plateau fracture. The study was based on register data from the Danish National Patient Register. Results: The study included 7950 patients sustaining 8065 tibial plateau fractures. The cohort had a mean follow-up period of 13.9 years. Patients with a tibial plateau fracture had a 1.52 (95% CI 1.46–1.58) times higher hazard ratio (HR) of death compared to the age- and gender-matched reference population. The 30-day, 6-month and 1-year mortality rates were 1.2%, 3.3% and 4.9%, respectively. Conclusion: Patients with a proximal tibial plateau fracture have a higher cumulative risk of death during the mean 13.9-year observational period compared to an age- and gender-matched reference population.