Treatment of Type V and Type VI Schatzker Tibial Plateau Fractures: Comparison of Functional and Radiological Outcomes of Open Reduction and Internal Fixation using Lateral Lock Plate and Bicondylar Plating – A Randomized Control Trial
|IJOCP | June 2017 | Volume 2017 | Issue 2017 | Page 123
Conference: Central Zone of Indian Orthopaedic Association (CEZCON) – 2016, Kota, India [Click for full details]
Authors: Sagar Tontanahal, T D Bhattacharya, Rohit Ailani, Saksham Mittal
Authors Affiliations: Dept. of Orthopaedics, Guwahati Medical College and Hospital, Guwahati.
Address of correspondence: Dr.Sagar Tontanahal, Dept. of Orthopaedics, Guwahati Medical College and Hospital, Guwahati. E-mail: email@example.com
Background: Tibial plateau fractures are complex intra-articular fractures which pose a great challenge. The aim of this study compares the clinical and functional outcomes of type V and type VI tibial plateau fractures treated with bicondylar plating and lateral locking plate and to highlight their advantages and disadvantages.
Material & Methods: Forty patients in the age group of 18yrs to 65 Yrs with complex tibial plateau fractures (Schatzker Type V and VI) were operated between August 2014 and March 2016 either by a single lateral lock plate through an anterolateral incision or double plating through a double incision. The fractures were closed or grade one or two compounds with no other injury which hindered the post-op rehabilitation. All cases were followed up for a minimum for 12 months. The final functional assessment was done using the Knee Society Score.
Results: Twenty patients each were included in the two treatment groups having a mean age of 32.97 years. The most common mode of injury was road traffic accidents, accounting for 70% (28) of the cases. The average duration for the union in case of lateral lock plate (ULP) was 12.7 weeks (range: 8 – 16 weeks) and in bi-condylar plating (BCP) was 14.5 weeks (range: 10 – 20 weeks), the difference was found to be insignificant. The average operating time in ULP was 66.25 mins (range: 50 – 90 mins) while that of BCP was 96.75 mins (range: 90 – 140 mins). This difference was found to be significant (p=0.001). The difference in average blood loss was also found to be significant (p=0.0015) with an average of 59.5 ml (range: 30 – 90 ml) in ULP and 76 ml (range: 60 – 110 ml) in BCP. The difference between the average Knee Society Score between the two groups was found to be insignificant (p=0.3142) with an average score of 92.85 in ULP and 90.5 in BCP. Postoperative loss of alignment was seen in 5 cases only in the unilateral plating group, all of which showed varus malalignment. Superficial infections were more common in BCP (4 cases) compared to ULP (2 cases).
Conclusion: This study concluded that overall, either of the fixation modalities showed good functional results. The anterolateral lock plate had certain advantages like reduced operating time, blood loss, and reduced infection rates. The bicondylar plating however offered better maintenance of articular congruity post fixation.
Tibial plateau; lateral lock plate; bicondylar plating; functional outcomes
|How to Cite this Abstract|
|Tontanahal S, Bhattacharya T D , Ailani R, Mittal S. Treatment of Type V and Type VI Schatzker Tibial Plateau Fractures: Comparison of Functional and Radiological Outcomes of Open Reduction and Internal Fixation using Lateral Lock Plate and Bicondylar Plating – A Randomized Control Trial. International Journal of Conference Proceedings December 2016;(2016):123|