Functional outcome of Schatzker type V and VI tibial plateau fractures managed by open reduction and internal fixation using dual plates

M. Ali Haider; M. Iqbal Hossain; Wakil Ahmed; Jabed Jahangir Tuhin; Ratan Kumar Paul; M. Rashed Hasan; M. Hasibuzzaman

doi:10.18203/issn.2455-4510.IntJResOrthop20243883

Authors

M. Ali Haider Department of Orthopaedics, 250 Bedded General Hospital, Kushtia, Bangladesh
M. Iqbal Hossain Department of Orthopaedics, Chattogram Medical College Hospital, Chattogram, Bangladesh
Wakil Ahmed Department of Orthopaedics, National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka, Bangladesh
Jabed Jahangir Tuhin Department of Orthopaedics, Chattogram Medical College Hospital, Chattogram, Bangladesh
Ratan Kumar Paul Department of Orthopaedics, Kushtia Medical College, Kushtia, Bangladesh
M. Rashed Hasan Department of Orthopaedics, 250 Bedded General Hospital, Kushtia, Bangladesh
M. Hasibuzzaman Department of Orthopaedics, National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20243883

Keywords:

Tibial plateau fractures, Schatzker type V and VI, Open reduction, Internal fixation, Functional outcome

Abstract

Background: High-energy bicondylar tibial plateau fractures (Schatzker type V and VI) occur as a result of road traffic accidents, falls from height, and sports injuries, and mostly affect the younger age group in productive life years. This study aimed to evaluate the functional outcome of high-energy tibial plateau fractures (Schatzker type V and VI) treated by dual plating through anterolateral and posteromedial incisions.

Methods: This was a hospital-based clinical trial study conducted in the department of orthopaedics and traumatology, Chittagong medical college hospital, Chattogram, Bangladesh, from January 2018 to December 2019. Our study included 50 adult patients of both genders with high-energy tibial plateau fractures through a consecutive sampling technique. The knee function of the patients was evaluated according to the Oxford knee scoring system.

Results: Out of 50 cases, 38 cases (76%) were male and 12 cases (24%) were female with a mean±SD age was 43.95±10.89 years. All the cases (100%) were due to RTA, 70% had Schatzker type VI and 30% had type V injury. Mean±SD time interval from injury to fixation was 11.05±3.20. The average duration of operation in minutes was 107.0 (±12.07). At the final follow-up, 41 (82%) and 05 (10%) patients had excellent and good outcomes respectively.

Conclusions: Open reduction and internal fixation in high-energy tibial plateau fractures using dual plates through two incisions can provide excellent to good functional results and minimal soft tissue complications in appropriately selected cases.

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References

Canale TS, Beaty JH. Campbell’s Operative Orthopaedics: Fractures of lower extremity: Tibial plateau. 11th ed. Vol 3. Philadelphia: Mosby Elsevier. 2007;2094-111.

Rockwood CA, Green DP. Fractures of the proximal tibia and fibula. In: Bucholz RW, Heckman JD, editors. Rockwood and Green’s fractures in adults. 5th ed vol 2. Philadelphia: Lippincott Williams and Wilkins. 2001;1799-839.

Ali AM, Yang L, Hashmi M, Saleh M. Bicondylar tibial plateau fracture managed with the Sheffield Hybrid Fixator: Biomechanical study and operative technique. Injury. 2001;32(4):SD86-91.

Berkson EM, Virkus WW. High-energy tibial plateau fractures. J Am Acad Orthop Surg. 2006;14(1):20-31.

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.

Chin TYP, Bardana D, Bailey M, Williamson OD, Miller R, Edwards ER, et al. Functional outcome of tibial plateau fractures treated with the fine-wire fixator. Injury. 2005;36(12):1467-75.

Mueller KL, Karunakar MA, Frankenburg EP, Scott DS. Bicondylar tibial plateau fractures: a biomechanical study. Clin Orthop Relat Res. 2003;412:189-95.

Ruffolo MR, Gettys FK, Montijo HE, Seymour RB, Karunakar MA. Complications of high-energy Schatzker, J, McBroom R, Bruce D. The tibial plateau fracture: The Toronto experience 1968-1975. Clin Orthop Relat Res. 1979;138:94-104.

Barei DP, Nork SE, Mills WJ, Henley MB, Benirschke SK. Complications associated with internal fixation of high-energy bicondylar tibial plateau fractures utilizing a two-incision technique. J Orthop Trauma. 2004;18:649-57.

Cho K, Oh H, Yoo J, Kim D, Cho Y, Kim K. Treatment of tibial plateau fractures using a midline incision and dual plating. Knee Surg Relat Res. 2013;25(2):77-83.

Rohra N, Suri HS, Gangrade K. Functional and radiological outcome of Schatzker type V and VI tibial plateau fracture treatment with dual plates with minimum 3 years follow-up: A prospective study. J Clin Diagn Res. 2016;10(5):RC05-10.

Nawaz S, Afghan S, Lodhi R. Outcome of using hybrid Ilizarov external fixator in the treatment of Schatzker type V and VI tibial plateau fractures. PJMHS. 2017;11(1):432-4.

Tahir M, Kumar S, Shaikh SA, Jamali AR. Comparison of postoperative outcomes between open reduction and internal fixation and Ilizarov for Schatzker type V and type VI fractures. Cureus. 2019;11(6):e4902.

Yu Z, Zheng L, Zhang Y, Li J, Ma B. Functional and radiological evaluations of high energy tibial plateau fractures treated with double-buttress plate fixation. Eur J Med Res. 2009;14(5):200-5.

Bari MM, Islam S, Shetu NH, Mahfuzer RM. Complex tibial plateau fractures treated with Ilizarov ring fixator. MOJ Orthop Rheumatol. 2014;1(2):28-30.

Dawson J, Fitzpatrick R, Murray D, Carr A. Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br. 1998;80(1):63-9.

Khatri K, Lakhotia D, Sharma V, Kumar GNK, Sharma G, Farooque K. Functional evaluation in high energy (Schatzker type V and type VI) tibial plateau fractures treated by open reduction and internal fixation. Int Scholarly Res Notices. 2014;589538:8.