Functional and radiological outcome of surgically treated tibial plateau fractures

Abstract

Background: Tibial plateau fractures are difficult to treat. The spectrum of treatment ranges from simple casting and bracing to skeletal traction and open reduction and internal fixation. Material and Method: The present study included 30 patients (17 males; 13 females, mean age 40.33±12.7 years; range, 18 to 65 years) with tibial plateau fractures who were treated with various modalities. In our series, all patients were treated operatively out of which 15 (50.0%) were managed by ORIF with lateral plate, 8 (26.7%) patients were managed by CRIF with CC screw, 4 (13.3%) ORIF with lateral plate with CC screw, 2 (6.7%) ORIF with medial plate and 1 (3.3%) CRIF with CC screw. In all patients, similar standard physical rehabilitation therapy was followed. All complications including intra and post-operative were assessed and recorded. Results: The functional outcome was assessed using Harkonen-Jarvinen criteria after a mean follow-up of 8 months. The statistical analysis was done using the paired t-test. All patients showed excellent or good results according to H J criteria. In the present study, there were no cases of secondary loss of reduction, failure of the implant, malunion, or non-union. Conclusion: The surgical management of tibial plateau fractures is an orthopaedic challenge and needs a comprehensive understanding of fracture, soft tissue, time interval from injury to surgery and post-operative rehabilitation. Modalities like LCP in MIPPO and bone grafting can give excellent results in desirable patients but requires an optimum learning curve.

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