Clinico-radiological and functional outcomes of bicolumnar plating in schatzker type 5 and type 6 fractures of proximal tibia in tertiary care hospital in North India: a series of 26 patients

Authors

  • Pankaj Vir Singh Department of Orthopaedics, Government Medical College, Jammu, Jammu and Kashmir, India
  • Gagandeep Singh Department of Orthopaedics, Government Medical College, Jammu, Jammu and Kashmir, India
  • Manmeet Singh Department of Orthopaedics, Government Medical College, Jammu, Jammu and Kashmir, India
  • Abdul Ghani Department of Orthopaedics, Government Medical College, Jammu, Jammu and Kashmir, India
  • Amarjeet Singh Department of Orthopaedics, Government Medical College, Jammu, Jammu and Kashmir, India
  • Zubair A. Lone Department of Orthopaedics, Government Medical College, Jammu, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20211894

Keywords:

Tibial plateau fractures, Schatzker, Bicolumnar plating

Abstract

Background: Ideal mode of treatment is always debatable for Schatzker type 5 and type 6 fractures in proximal tibia. The aim of the study was management in tibial plateau fracture are to obtain anatomic reduction of the articular surface, restoration of axial alignment, and achieve stable fixation which can be done by open reduction and internal fixation (ORIF) using bicolumnar plating.

Methods: 26 patients with Schatzker type 5 and type 6 fractures were managed by bicolumnar plating. They were followed up to six months in terms of radiological union, functional outcomes and complications. Functional outcome at the end of follow up was assessed using knee society scoring system.

Results: Good to excellent results were obtained in almost all the patients using knee society scoring system, mean knee ROM achieved was 114.5 degree. Average time to achieve radiological union was 14.4 weeks. These results were in comparison with the studies done earlier.

Conclusions: Bicolumnar plating is an effective method of treatment of Schatzker type 5 and type 6 fractures and provide excellent result in expert hands. Rehabilitation using early CPM (continuous passive movement) is very effective in reducing the post-operative complications like knee stiffness.

 

References

Coster TA, Nepola JV, el-Khoury GY. Cast brace treatment of proximal tibia fractures. A ten-year follow-up study. Clin Orthop Relat Res. 1988;(231):196-204.

Schatzker J, Mc BR, Bruce D. The tibial plateau fracture. The Toronto experience 1968-1975. Clin Orthop Relat Res. 1979;138:94-104.

Schulak DJ, Gunn DR. Fractures of tibial plateaus. A review of the literature. Clin Orthop Relat Res. 1975;(109):166-77.

Rockwood CA, David P, Green D, Robert W. Fractures of the proximal tibia and fibula. In: Bucholz RW, Heckman JD, Charles M, Court B, eds. Rockwood and Green's fractures in adults. 6th ed. United States, Philadelphia: Lippincott Williams & Wilkins; 2006: 1725-61.

Zhang Y, Fan DG, Ma BA, Sun SG. Treatment of complicated tibial plateau fractures with dual plating via a 2-incision technique. Orthopedics. 2012;35(3):359-64.

Prasad GT, Kumar TS, Kumar RK, Murthy GK, Sundaram N. Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates. Indian J Orthop. 2013;47(2):188-94.

Eggli S, Hartel MJ, Kohl S, Haupt U, Exadaktylos AK, Roder C. Unstable bicondylar tibial plateau fractures: a clinical investigation. J Orthop Trauma. 2008;22(10):673-9.

Hasankhani G, Omidi EK, Hassankhani FG, Golnaz. Treatment of Complex Proximal Tibial Fractures (Types V & VI of Schautzker Classification) by Double Plate Fixation with Single Anterior Incision. Open Journal of Orthopedics. 2013;3:208-12.

Luo CF, Jiang R, Hu CF, Zeng BF. Medial double-plating for fracture dislocations involving the proximal tibia. Knee. 2006;13(5):389-94.

Gosling T, Schandelmaier P, Muller M, Hankemeier S, Wagner M, Krettek C. Single lateral locked screw plating of bicondylar tibial plateau fractures. Clin Orthop Relat Res. 2005;439:207-14.

Bhalotia AP, Ingle MV, Koichade MR. Necessity of dual plating in bicondylar tibial plateau fracture dislocations: A prospective case series. J Orthop Traumatol Rehabil 2018;10:29-33.

Stannard JP, Wilson TC, Volgas DA, Alonso JE. The less invasive stabilization system in the treatment of complex fractures of the tibial plateau: short-term results. J Orthop Trauma. 2004;18(8):552-8.

Neogi DS, Trikha V, Mishra KK, Bandekar SM, Yadav CS. Comparative study of single lateral locked plating versus double plating in type C bicondylar tibial plateau fractures. Indian J Orthop. 2015;49(2):193-8.

Faisal. Treatment of Type V and Type VI Schatzker Tibial Plateau Fractures: Comparision of Functional and Radiological Outcomes of Open Reduction and Internal Fixation Using Lateral Lock Plate and Bicondylar Plating- A Randomized Control Trial. IOSR J of Dental and Med Sci. 2020;19(11):35-8.

Yao Y, Lv H, Zan J, Li J, Zhu N, Jing J. Functional outcomes of bicondylar tibial plateau fractures treated with dual buttress plates and risk factors: a case series. Injury. 2014;45(12):1980-4.

Shah SN, Karunakar MA. Early wound complications after operative treatment of high energy tibial plateau fractures through two incisions. Bull NYU Hosp Jt Dis. 2007;65(2):115-9.

Lee MH, Hsu CJ, Lin KC, Renn JH. Comparison of outcome of unilateral locking plate and dual plating in the treatment of bicondylar tibial plateau fractures. J Orthop Surg Res. 2014;20(9):62.

Barei DP, Mara TJ, Taitsman LA, Dunbar RP, Nork SE. Frequency and fracture morphology of the posteromedial fragment in bicondylar tibial plateau fracture patterns. J Orthop Trauma. 2008;22(3):176-82.

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Published

2021-06-23

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Original Research Articles