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Research Paper | Medical Surgical | India | Volume 6 Issue 11, November 2017 | Popularity: 6.7 / 10
Clinico-Radiological Outcome of Bicondylar Tibial Plateau Fracture Treated with Dual Incision and Dual Pre-contoured Locking Plate: A Prospective Study
Dilip Soring, Sanjib Waikhom, S. N. Chishti, Khoda Tada, Shams Gulrez, Rajkumar Debbarma
Abstract: High energy tibial plateau fractures remain a challenge to orthopaedic surgeons, with the Schatzkers type-V (bicondylar) and the Schatzkers type-VI fracture being the most difficult to treat. Bicondylar fracture account for 10 to 30 % of all tibial plateau fracture with a significant number of perioperative complications.3-6 There is a controversy regarding a number of issue pertaining to the management of this fracture, including classifications, surgical approach and method of fixation. Early management of these fracture are critical for minimizing patient disability and reducing the risk of complication. The purpose of this study is to compare the long term functional, clinical and radiological outcome of bicondylar tibial plateau fracture. Materials and Methods A prospective study was carried out from September 2015 to October 2017. We studied 32 patient bicondylar tibial plateau fracture and each patient were treated with dual incision and dual pre-contoured locking plate. The patient was followed up for minimum of 18 months. The final outcome was assessed using modified Rasmussens clinical and radiological criteria. Results The modified Rasmussens functional outcome at the final follow up ( 18 months) was excellent in 15 (46.9 %) patient, good in 12 (37.5 %), fair in 4 (12.5 %) and poor in 1 (3.1 %) patient. The average Rasmussens functional score was 26.7 (range, 19 30). Discussion & conclusion Osteosynthesis in bicondylar tibial plateau fractures in adults is a challenge to every orthopaedic surgeon. Though there are number of implants and surgical techniques to address the problem, the surgical treatment of tibial plateau fracture remain controversial. We recommend to fix the bicondylar tibial plateau fracture with dual incision and dual pre-contoured locking plate as it provide good surgical exposure, minimal soft tissue complications rate, reasonable amount of stability, acceptable alignment of articular congruity, reasonable time to union and allow early range of motion of knee & early weight bearing with good functional
Keywords: Bicondylar tibial plateau fracture, Schatzker classification, modified Rasmussens criteria, dual incision technique with dual pre-contoured locking plate
Edition: Volume 6 Issue 11, November 2017
Pages: 992 - 999
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