OutcomeAnalysis of dual plating in bicondylar fracture of Tibia.
Abstract
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.
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References
Schatzker JO, MCBROOM R, BRUCE D. The Tibial Plateau Fracture: The Toronto Experience 1968-1975. Clinical orthopaedics and related research. 1979 Jan 1;138:94-104.
Segal D, Mallik AR, Wetzler MJ, Franchi AV, Whitelaw GP. Early weight bearing of lateral tibial plateau fractures. Clinical orthopaedics and related research. 1993 Sep 1;294:232-7.
Barei DP, Nork SE, Mills WJ, Coles CP, Henley MB, Benirschke SK. Functional outcomes of severe bicondylar tibial plateau fractures treated with dual incisions and medial and lateral plates. J Bone Joint Surg Am. 2006 Aug 1;88(8):1713-21.
Partenheimer A, Gösling T, Müller M, Schirmer C, Kääb M, Matschke S, Ryf C, Renner N, Wiebking U, Krettek C. [Management of bicondylar fractures of the tibial plateau with unilateral fixed-angle plate fixation]. Der Unfallchirurg. 2007 Aug;110(8):675-83
Oh CW, Oh JK, Kyung HS, Jeon IH, Park BC, Min WK, Kim PT. Double plating of unstable proximal tibial fractures using minimally invasive percutaneous osteosynthesis technique. Acta orthopaedica. 2006 Jan 1;77(3):524-30
Babis GC, Evangelopoulos DS, Kontovazenitis P, Nikolopoulos K, Soucacos PN. High energy tibial plateau fractures treated with hybrid external fixation.Journal of Orthopaedic Surgery and Research. 2011;6:35. doi:10.1186/1749-799X-6-35
Cole PA, Zlowodzki M, Kregor PJ. Treatment of proximal tibia fractures using the less invasive stabilization system: surgical experience and early clinical results in 77 fractures. Journal of orthopaedic trauma. 2004 Sep 1;18(8):528-35.
Sarmiento, A.: Functional Bracing of Tibial fractures. ClinOrthopRelat Res. 105;202,1974
Moore TM, Patzakis MJ, Harvey JP. Tibial plateau fractures: definition, demographics, treatment rationale, and long-term results of closed traction management or operative reduction. J Orthop Trauma. 1987; 1(2):97–119. doi:10.1097/00005131-198702010-00001
Young MJ, Barrack RL, Complications of internal fixation of tibial plateau fractures. Orthop Rev. 1994 Feb;23 (2):149-54.
Jiang R, Luo CF, Wang MC, Yang TY, Zeng BF. A comparative study of Less Invasive Stabilization System (LISS) fixation and two-incision double plating for the treatment of bicondylar tibial plateau fractures. The Knee. 2008 Mar 31;15(2):139-43.
Ali AM, El-Shafie M, Willett KM. Failure of fixation of tibial plateau fractures. Journal of orthopaedic trauma. 2002 May 1;16(5):323-9.
Phisitkul P, Mckinley TO, Nepola JV, Marsh JL. Complications of locking plate fixation in complex proximal tibia injuries. Journal of orthopaedic trauma. 2007 Feb 1;21(2):83-91.
Yercan HS, Sugun TS, Bussiere C, Selmi TA, Davies A, Neyret P. Stiffness after total knee arthroplasty: prevalence, management and outcomes. The knee. 2006 Mar 31;13(2):111-7.
Lachiewicz. P.F., Funcik T.: Factors influencing the results of open reduction and internal fixation of Tibial platean fractures ClinOrthop. October 1990; 259:210-15.
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