A prospective study of functional outcome of posteromedial plating in the management of complex tibial plateau fractures

Abstract

Tibial plateau fractures have a complicated intra articular fracture pattern, representing approximately 1.2% of all fractures. The occurrence of posteromedial fragment is relatively common in high energy tibial plateau fractures Aims and Objectives: To study the role of posteromedial plating in management of complex tibial plateau fractures with a posteromedial fragment. Materials and methods: 26 cases above 25 years of age, from the patient admitted to Rajah Muthaiah Medical College and Hospital, Annamalai University, Chidambaram with posteromedial fragment in tibial plateau fractures that were operated between May 2016 to May 2018 were undertaken for the study. Reduction can be maintained with a Kirchner wire and a pointed reduction clamp. The plate is placed directly over the area of maximal displacement at the apex of the fracture. Results: Of the 26 patients with type IV, V and VI Schatzker’s tibial plateau fractures from x ray and CT scan of knee joint, 24 had pre contoured posteromedial plate and 2 patients had recon plate where the fragment was comparatively small and comminuted. We analysed patients with Rasmussen scoring postoperatively. In our analysis among 26 patients, functional score were excellent in 20, Good in 3, Fair in two and poor in one patient. There was one patient with grade I compound injury who had developed infection that later resolved after wound wash and resuturing on the 5th postoperative day with judicial use of antibiotics. One patient had collapse due to premature weight bearing. Two patients had transient paraesthesia of the saphenous nerve; both resolved completely.

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