The outcome of Complex Tibial plateau fractures (Schatzker type V and VI) treated with Dual plates

Abstract

Background: Isolated lateral locked plating does not provide sufficient fixation to resist collapse of the medial condyle, leading to loss of axial alignment of the limb, producing varus deformity and poor long-term outcome. dual locked plating of bicondylar tibial plateau fractures are required to reduces the risk of mal-reduction and loss of reduction and prevents post traumatic osteoarthritis. Hence we evaluated functional and radiological outcome of dual locking plates in proximal tibial plateau fractures Schatzker type V and VI.

Material & Methods: Twenty-two cases of tibial plateau fractures Schatzker type V and VI treated with dual locking plates, antero-lateral and medial buttress plating were evaluated for functional outcome using Knee Society Score and radiological outcome was evaluated for union and alignment by modified Rasmussen radiological assessment score.

Results: A total of 22 patients with mean age 34 years (range 22 to 49 years) were included in the study. 16 were male and 6 were female. The mean delay in surgery was 5.3 days (range 3 to 9 days). All Fractures were united at mean duration of 14.4 weeks, and the mean time to full weight-bearing was 12 weeks. The mean range of knee motion was 121°. The mean knee severity score was 85. 18 patients had excellent results, 2 had good results, 1 had fair result and 1 had poor result as per Knee severity score. As per Rasmussen radiological assessment score 20 had excellent and one each had good and fair results and none of the patient had poor results. Two with superficial infection and one had hardware prominence but none of the patients had non-union, arthritis or secondary loss of reduction.

Conclusion: Schatzker type V and VI fractures require double plate fixation for optimal stability, which prevents secondary loss of reduction and varus/ valgus collapse of the fracture and provides excellent radiological and function outcome.