DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20212435

Dual plate osteosynthesis in bicondylar tibial plateau fractures-case series

Shreekantha Koteshwara Surendra Rao, Mahammad Aseem Mahammadgous Mulla, Deepak Malik, Mohammed Usman

Abstract


Tibial plateau fractures accounts for about 1% of injuries. Various mechanisms have been described, resulting in milder form to serious injuries depending upon force of impact.  High velocity injuries resulted from valgus or varus impacted forces combined with axial loading such as in Schatzker type 6. The ideal method of treatment for these fractures is always a matter of debate. As all intra-articular fractures necessitate anatomic reduction of the articular surface, restoration of axial alignment, and stable fixation, which can be achieved very well by open reduction and internal fixation (ORIF) with dual plating. To study the functional and radiological outcome of Tibial plateau fractures treated surgically with dual plate osteosynthesis. 15 patients in the age group 18-60 were included. Rasmussens criteria was used to assess the functional and radiological outcomes with follow up period of 1 year prospectively. The outcome assessment using Rasmussens score concluded good results. The average duration for union was ­6 months. ROM achieved in these patients were to be at least 124 degrees. The infection rate in this study was accounted as 13.3%. Open reduction and internal fixation of tibial plateau fractures, by dual plating has good functional and radiological outcome. This is an effective method of treatment even with moderate soft tissue injury if meticulous surgical technique, appropriate soft tissue handling and adequate healing period given. All these have shown to decrease the postoperative complications such as infection.


Keywords


Tibial plateau fractures, Schatzker type VI, Dual plate osteosynthesis, Rasmussens score

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References


Li DQ, Song DY, Ni JD, Ding ML, Huang J. A case report of Schatzker type VI tibial plateau fracture treated with double reverse traction closed reduction combined with minimally invasive percutaneous plate osteosynthesis technique: A case report. Medicine. 2017;96:45.

Bhalotia AP, Ingle MV, Koichade MR. Necessity of dual plating in bicondylar tibial plateau fracture dislocations: A prospective case series. J Orthop Traumatol Rehabilitation. 2018;10(1):29.

Manjunath J, Ashish BC, Shashidhara H, Rao V. A prospective study of surgical management of bicondylar schatzker type V and VI tibial plateau fracture by dual plating and dual incision. Int J Orthop. 2019;5(3):46-54.

Rajappan DR, Ravikumar V, Suhail AP. Functional outcome of tibial plateau fractures, Schatzker type V and VI treated surgically with plate osteosynthesis. National J Clin Orthop. 2018;2(2):35-46.

Cho KY, Oh HS, Yoo JH, Kim DH, Cho YJ, Kim KI. Treatment of Schatzker type V and VI tibial plateau fractures using a midline longitudinal incision and dual plating. Knee surgery and related research. 2013;25(2):77.

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;47:188-94.

Paleti ST, Kumar RN. Assessing the functional and Radiological outcome in surgically treated closed tibial plateau fractures in adults: A case series of 40 cases. Int J Orthop. 2019;5(1):472-6.

Marsh JL, Mattew Karam D. Tibial plateau fractures: chapter 55 Rockwood and Green fracture in adult’s 8th editon Wolters Kluwer health. 2015;2.

Barei DP, Sean Nork E, William Mills J, Chad Coles P, Bradford Henley M, Stephen Benirschke K. Functional Outcomes of Severe Bicondylar Tibial Plateau Fractures Treated with Dual Incisions and Medial and Lateral Plates. J Bone Joint Surg. 2006;88-a:8.

Mark Miller D. Review of orthopaedics. Basic Sci. 1992;1:42.

Rudloff MI. Fractures of the Lower Extremity, in Campbell's Operative Orthopaedics Elsevier. 2013;2668-724.