Functional and radiological outcome of bicondylar tibial plateau fractures treated with dual buttress plating

Volume 16 | Issue 2 | April-June 2021 | Page 18-21 | Aneesh Joseph, Balu C Babu, Druvan Shaji, Vipin Mohan, Nandu Krishnan, Shyam S Anand


Authors: Aneesh Joseph [1], Balu C Babu [1], Druvan Shaji [1], Vipin Mohan [1], Nandu Krishnan [1], Shyam S Anand[1].

[1] Department of Orthopaedics, Amrita Institute of Medical Sciences, Kochi, India.

Address of Correspondence
Dr. Aneesh Joseph,
Amrita Institute of Medical Sciences, Kochi, India
E-mail: draneeshalapatt@gmail.com


Abstract

Background: There are different ways to treat bicondylar tibial plateau fractures, treatment remains a challenge to most orthopaedic surgeons. The objective of the study is to analyse the functional and radiological outcomes of bicondylar tibial plateau fractures treated with dual plating.
Methods: Clinical data of 80 patients are prospectively and retrospectively reviewed from March 2012 to March 2019. All patients were evaluated both radiographically and clinically according to Rasmussen score, Hospital for special surgery (HSS) and Rasmussen functional knee score.
Results: Rasmussen anatomic score was excellent in 49 patients, good in 29, and fair in the remaining 2 patients. Functional results using Rasmussen functional score was excellent in 45, good in 32, fair in 1 and poor in 2. Functional results using HSS score was excellent in 41, good in 21, fair in 16, and poor in 2.
Conclusion: Bicondylar tibial plateau fracture have excellent to good functional and radiological outcome with dual plating. Early mobilization of the joint provides good range of motion.
Keywords: Bicondylar tibial plateau, Dual plating.


References

1. J. Schatzker, “Fractures of the Tibial Plateau,” in The Rationale Of Operative Fracture Care, 2005, pp. 447-469
2. 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.
3. Mathew.I.Rudloff, “Fractures of the Lower Extremity,” in Campbell’s Operative Orthopaedics, Elsevier, 2013, pp. 2668-2724.
4. Duwelius PJ, Connolly JF. Closed reduction of tibial plateau fractures. A comparison of functional and roentgenographic end results. Clin Orthop Relat Res. 1988;(230):116–126.
5. E. G. Hassankhani, “Treatment of Complex Proximal Tibial fractures ( Type 5 & 6 Scatzker Classification ) by Double Plate fixation with Single Anterior Incision .,” Open Journal Of Orthopaedics ; 3 , pp. 208212, 2013.
6. Lansinger O, Bergman B, Korner L, et al. Tibial condylar fractures. A twenty-year follow-up. J Bone Joint Surg Am. 1986;68(1):13–19.
7. Apley AG. Fractures of the lateral tibial condyle treated by skeletal traction and early mobilisation; a review of sixty cases with special reference to the long-term results. J Bone Joint Surg Br. 1956;38- B(3):699–708.
8. Sarmiento A, Kinman P B, Latta L L, Fracture of Proximal Tibia and Tibial Condyles, Clin Orthop, 1979:145:136-45
9. P. M. Pelsar, “Controversies in the management of tibial plateau fractures,” SA Orthopaedic Journal, p. 75, 2010.
10. T. B. Pun, “Outcome of Schatzker type 5 and type 6 fractures,”Indian Journal of Orthopaedics; volume 48 ; Issue 1 , 2014.
11. Y. Zhang, “Treatment of Complicated Tibial Plateau fractures with Dual Plating via 2 incision technique,” Orthosupersite.com; volume 35; number 3, 2012.
12. G. Prasad, “Functional Outcome of Schatzker Type 5 and 6 TibialPlateau fractures treated with dual plates,” Indian Journal of Orthopaedics ; vol.47 ; Issue 2 , 2013.
13. C.-W. Oh, “Double plating of unstable proximal tibial fractures using minimally invasive percutaneous osteosynthesis technique,” Acta Orthopaedia ; 77 (3) , pp. 524-530, 2006.
14. E. e. al, “Unstable Bicondylar Tibial Plateau Fractures : A Clinical Investigation,” J Orthop Trauma , pp. 673 – 679 , 2008 ; 22.
15. N. S. ,. M. W. e. a. Barie DP, “Complications associated with internal fixation of High energy bicondylar tibial plateau fractures utilising a two incision technique,” J Orthop Trauma , vol. 18, 2004.
16. V. e. al, “New Trends and technique in open reduction and internal fixation of fractures of tibial plateau,” J Bone Joint Surg [ Br ], Vols. 91 – B, 2009.
17. B. e. al, “Functional outcomes of severe bicondylar tibial plateau fractures treated with dual incision and medial and lateral plates,” J Bone and Joint Surgery [ Am ] , Vols. 88-A, 2006.
18. P. V. Freeman MA, “The movement of normal Tibiofemoral joint,” J Biomech , vol. 38, 2005.
19. M. L. 3. ,. H. M. ,. e. a. Bhattacharyya T, “The posterior shearing tibial plateau fracture : treatment and results via a posterior approach,” J Orthop Trauma , vol. 19, 2005.
20. P. A. ,. T. G. ,. e. a. Papagelopoulous PJ, “Complication after tibial plateau fracture surgery,” Injury , vol. 37, 2006.
21. H. G. Jacofsky DJ, “Tibial Plateau Fractures,” In:Scott WN. Insall & Scott Surgery of Knee . Churchill Livingston .Elsevier , 2006.
22. E. M. e. al, “Reliability of Locked PLating in Tibial Plateau fractures with medial component,” Orthop Traumatol Surg Res , vol. 98, 2012.
23. R. J. ,. B. J. J. Ricci WM, “Treatment of complex proximal tibia fractures with less invasive skeletal stablization system,” J Orthop Trauma , vol. 18, 2004.
24. M. T. ,. N. J. ,. M. J. Phisitkul P, “Complications of locking plate fixation in complex proximal tibial injuries,” J Orthop Trauma , vol. 21, pp. 83-91, 2007.
25. C. O. T. Society, “Open Reduction and Internal fixation compared with circular fixator application for bicondylar tibial plateau fractures .Results of a multicenter , prospective randomised clinical trial,” J Bone and Joint Surg [ Am ], vol. 88, pp. 2613-2623 , 2006 .
26. M. M. ,. R. M. ,. e. a. Gosling T, “The Less Invasive Stablization system for Bicondylar fractures of the proximal tbia,” Orthopaedic Trauma Association 18 Annual Meeting , Toronto , Canada . , 2002 .
27. J. Watson, “Tibia – Proximal,” in AO Principles of Fracture Management , 2000, pp. 499-519 .
28. M. Williams J Mills MD and Sean E. Norle, “ORIF of high energy tibial plateau fractures,” OCNA , vol. 33 , p. 177 , 2002.
29. H. D. Koval KJ, “Tibial plateau fractures – Evaluation and treatment,” J.Am.Acad.Orthop.Surg , vol. 3(2), pp. 86-94, 1995.
30. M. R. ,. B. D. Schatzker J, “The tibial plateau fracture . The Toronto Experience 1968 – 1975,” Clin Orthop , vol. 138, pp. 94-104, 1979 .


How to Cite this article: Joseph A, Babu BC, Shaji D, Mohan V, Krishnan N, Anand SS. Functional and radiological outcome of bicondylar tibial plateau fractures treated with dual buttress plating. Journal of Trauma and Orthopaedic Surgery April-June 2021;16(2): 18-21.

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