Outcome Analysis of Dual Plating in Management of Unstable Bicondylar Tibial Plateau Fracture - A Prospective Study
https://doi.org/10.5704/MOJ.2111.005
- Author:
Raj M
1
;
Gill SPS
2
;
Rajput A
2
;
Singh KS
2
;
Verma KS
2
Author Information
1. Department of Orthopaedics, All India Institute of Medical Sciences, Deoghar, India
2. Department of Orthopaedics, Uttar Pradesh University of Medical Sciences, Etawah, India
- Publication Type:Journal Article
- Keywords:
unstable bicondylar tibial plateau fracture, Schatzker type V and VI, Rasmussen’s criteria, oxford knee score, radiological outcome
- From:Malaysian Orthopaedic Journal
2021;15(No.3):29-35
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Bicondylar tibial plateau fractures account for
10-30% of tibial plateau fractures. Despite recent
advancements in the management of unstable bicondylar
tibial plateau fractures, the outcomes are often poor. The
present study aimed to evaluate the functional outcomes and
complications of internal fixation of bicondylar tibial plateau
fractures with the dual plating using two incisions.
Materials and methods: The present study included 30
patients (26 males; 4 females, mean age 35.6 years; range, 19
to 65 years) with bicondylar tibial plateau fractures who
were treated with dual plating between January 2017 to
August 2019. Out of 30 patients, 5 patients had Schatzker
type (V) and 25 patients had Schatzker type (VI) bicondylar
tibial plateau fracture. All patients were treated with dual
plating using two incisions. In all patient’s similar standard
physical rehabilitation therapy was followed. All
complications including intra and post-operative were
assessed and recorded. The patients were followed-up for
over 24 months. Functional outcomes were assessed with
Rasmussen’s functional grading system, Oxford knee score,
and range of motion of knee joint. Radiological outcomes
were evaluated using Rasmussen’s radiological scoring
system.
Result: All fractures united with a mean time of 18 weeks.
The average knee range of motion was 1.5° - 130° (range: 0°
- 10° for extension lag, range: 100° -135° for flexion). Mean
Rasmussen's functional grading score at the final follow-up
was 26.75. All patients showed excellent or good
radiographic results according to Rasmussen’s radiological
scoring with a mean score of 8.5 (range 6-10). The postoperative radiographs showed mean MPTA was 84.3° and
the mean PPTA was 6.2°. In the present study, complications
were encountered in five patients. However, there were no
cases of secondary loss of reduction, failure of the implant,
malunion, or non-union.
Conclusion: The surgical treatment of bicondylar tibial
plateau fractures with dual locking represents a significant
treatment option and provides rigid fixation in these fractures
with good functional and radiological outcomes.
- Full text:16.2021my1197.pdf
