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Lost to follow-up: reasons and outcomes following tibial plateau fractures

  • Original Article • LOWER LIMB - FRACTURES
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Introduction

Different reasons for lost to follow-up are assumed. Besides “objective” reasons, “subjective” reasons and satisfaction contribute to treatment adherence. Retrospective studies usually lack the possibility of acquisition of additional outcome information. Purpose of this study was to determine outcome and factors for patients not returning for follow-up.

Methods

Between 2002 and 2009, 380 patients underwent internal fixation for tibial plateau fractures. Short Musculoskeletal Function Assessment (SMFA) was collected at 6, 12, and 24 months as long as patients returned for follow-up. Pain and range of motion were measured. Records were studied for reasons of termination of follow-up. Statistical analysis was performed comparing lost to follow-up versus continued office visits regarding demographics, contributing factors, and SMFA.

Results

Two hundred fifty-nine patients were followed until treatment was completed (PRN), while 120 patients (32 %) terminated further follow-up. Patients in the 12- and 24-month follow-up groups were older (p = 0.02; p < 0.01, respectively). Pain (VAS ≥ 3) was noticed in 22 % of the patients terminating follow-up before the 6-month survey and 41 % of the patients returning for the 24-month SMFA survey (χ 2 = 0.06). Improvements were found with time in SMFA subscores but arm and hand. No differences in SMFA subscores at 6 or 12 months were found between those leaving treatment untimely and those being released from office visits.

Conclusion

Follow-up remains important to obtain as much up-to-date information as possible. The current study does not support the assumption that patients lost to follow-up have a different SMFA outcome than patients returning until PRN.

Level of evidence

III.

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Acknowledgments

We would like to thank Drs. Terrence Endres and James Ringler for the contribution of their patients and surgical skill.

Author information

Authors and Affiliations

  1. BG-University Hospital Bergmannsheil, Buerkle-de-la-Camp-Platz 1, 44789, Bochum, Germany

    Martin F. Hoffmann

  2. The Core Institute, Phoenix, AZ, USA

    Debra L. Sietsema & Clifford B. Jones

  3. Orthopaedic Associates of Michigan, Grand Rapids, MI, USA

    Debra L. Sietsema & Clifford B. Jones

Authors
  1. Martin F. Hoffmann
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  2. Debra L. Sietsema
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  3. Clifford B. Jones
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Corresponding author

Correspondence to Martin F. Hoffmann.

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Conflict of interest

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements) that might pose a conflict of interest in connection with the submitted article. No funding was received for this study.

Ethical standards

Approval was granted from the Spectrum Health—Grand Rapids Institutional Review Board. All procedures were in accordance with the ethical standards of the institutional and/or national research committee. The study was approved by the research ethics committee. Obtaining the informed consent from involved patients was waived by the research ethics committee. All procedures involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments.

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Hoffmann, M.F., Sietsema, D.L. & Jones, C.B. Lost to follow-up: reasons and outcomes following tibial plateau fractures. Eur J Orthop Surg Traumatol 26, 937–942 (2016). https://doi.org/10.1007/s00590-016-1823-6

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  • DOI: https://doi.org/10.1007/s00590-016-1823-6

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