OutcomeAnalysis of dual plating in bicondylar fracture of Tibia

Background: The operative treatment of bicondylar fractures of tibial plateau remains a challenging job. Treatment goals include, restoration of articular congruity and alignment in the lower extremity and preservation of soft tissues and achieving functional range of knee motion. With multitude of surgical procedures available, there still remains ambiguity regarding the ideal approach for tibial plateau fractures. The aim of this study is to evaluate the functional outcome of dual plating via two incisions for bicondylar tibial plateau fractures.

Methods: A prospective analytical cohort study was undertaken in the Department of Orthopaedics in Hamidia Hospital, Bhopal. Twenty eight patients who presented with Schatzker type V or VI tibial plateau fractures during the period of July 2014 to July 2016,were treated with dual plating via lateral plate through an anterolateral approach and a medial plate through an posteromedial approach. Rasmussen Functional criteria was used to evaluate functional outcome.

Results:Twenty-eight patients with tibial plateau fractures of Schatzker type V and VI treated by dual plating were analysed. The Mean range of motion at 14 weeks follow up was 1100.The mean time to union was 14.6 weeks.As per Rasmussen’s knee criteria, 57 % of patients had excellent results and 43% of patients had good results. The mean score was 26.54 (Range 21 - 29).Mean Functional Score was higher in patients with fractured fibula as compared to patients with intact fibula in patients with bicondylar tibial plateau fractures.

Conclusion: Treatment of BicondylarTibial Plateau Fractures (Schatzker type V & VI) with dual plating gives excellent functional outcome with a very low complication rate.