FUNCTIONAL AND RADIOLOGICAL OUTCOME OF TIBIAL PLATEAU FRACTURES MANAGED WITH INTERNAL FIXATION
DOI:
https://doi.org/10.22159/ajpcr.2022.v15i8.45274Keywords:
Tibial plateau fractures, Internal fixation, Knee Society score, Modified Rasmussen assessment criteriaAbstract
Objectives: Tibial plateau fractures constitute a wide spectrum of severity from simple to complex fracture patterns. Treatment methods such as internal fixation and hybrid external fixation are commonly administered with specific limitations. The present study was designed to evaluate radiological and functional outcome of tibial plateau fractures managed with internal fixation.
Methods: Thirty-six cases with tibial plateau fractures above 21 years were recruited. All the study cases were managed with open reduction and internal fixation. The post-operative follow-up was continued till 6 months with proper clinicoradiological evaluation to check range of motion, reduction loss, and fracture union. The functional outcome was assessed by Oxford Knee Society score and operative outcome was assessed by modified Rasmussen clinical and radiological criteria.
Results: Functional outcome assessed by Oxford Knee Society score showed both excellent and good outcomes in 91.67% of cases cumulatively. Clinical outcome by modified Rasmussen assessment criteria reported excellent outcome in 33.33%, good in 44.44%, fair in 13.88%, and poor in 8.33%. Radiological outcome was excellent in 16.6%, good in 63.88%, fair in 11.11%, and poor in 8.33%.
Conclusion: The post-operative functional, clinical, and radiological outcomes indicate that open or closed reduction and internal fixation had gained excellent results and are effective modalities in the management of tibial plateau fractures.
Downloads
References
Kawoosa AA, Mantoo SA, Ali N, Dar GN. Clinico-radiological results of tibial bicondylar fractures managed with Ilizarov technique with or without minimal internal fixation. Malays Orthop J 2022;16:18-27. doi: 10.5704/MOJ.2203.004, PMID 35519521
Elsoe R, Larsen P, Nielsen NP, Swenne J, Rasmussen S, Ostgaard SE. Population-based epidemiology of tibial plateau fractures. Orthopedics 2015;38:e780-6. doi: 10.3928/01477447-20150902-55, PMID 26375535
Kumar G, Peterson N, Narayan B. Bicondylar tibial fractures: Internal or external fixation? Indian J Orthop 2011;45:116-24. doi: 10.4103/0019- 5413.77130, PMID 21430865
Koval KJ, Helfet DL. Tibial plateau fractures-evaluation and treatment. J Am Acad Orthop Surg 1995;3:86-94. doi: 10.5435/00124635- 199503000-00004, PMID 10790657
Chang H, Zhu Y, Zheng Z, Chen W, Zhao S, Zhang Y, et al. Meta-analysis shows that highly comminuted bicondylar tibial plateau fractures treated by single lateral locking plate give similar outcomes as dual plate fixation. Int Orthop 2016;40:2129-41. doi: 10.1007/s00264- 016-3157-8, PMID 27008456
Nikolaou VS, Tan HB, Haidukewych G, Kanakaris N, Giannoudis PV. Proximal tibial fractures: Early experience using polyaxial locking-plate technology. Int Orthop 2011;35:1215-21. doi: 10.1007/s00264- 010-1153-y
Manidakis N, Dosani A, Dimitriou R, Stengel D, Matthews S, Giannoudis P. Tibial plateau fractures: Functional outcome and incidence of osteoarthritis in 125 cases. Int Orthop 2010;34:565-70. doi: 10.1007/s00264-009-0790-5, PMID 19440710
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;47:188-94. doi: 10.4103/0019- 5413.108915, PMID 23682182
Lee TC, Huang HT, Lin YC, Chen CH, Cheng YM, Chen JC. Bicondylar tibial plateau fracture treated by open reduction and fixation with unilateral locked plating. Kaohsiung J Med Sci 2013;29:568-77. doi: 10.1016/j.kjms.2013.01.006, PMID 24099112
Chin TY, 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;36:1467-75. doi: 10.1016/j. injury.2005.05.008, PMID 16243333
Watson JJ, Wiss AD. Rockwood and Green’s Fractures in Adults: Fractures of the Proximal Tibia and Fibula. Bucholz RW, Heckman JD, editors. 5th ed., Vol. 2. Philadelphia: Lip-pincott Williams and Wilkins; 2001. p. 1799-839.
Goh GS, Bin Abd Razak HR, Tay DK, Lo NN, Yeo SJ. Early post-operative oxford knee score and knee society score predict patient satisfaction 2 years after total knee arthroplasty. Arch Orthop Trauma Surg 2021;141:129-37. doi: 10.1007/s00402-020-03612-2, PMID 33044708
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:RC05-10. doi: 10.7860/JCDR/2016/18732.7855, PMID 27437315
Khatri K, Lakhotia D, Sharma V, Kiran Kumar GN, 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 Sch Res Notices 2014;2014:589538. doi: 10.1155/2014/589538, PMID 27379323
Wenger D, Petersson K, Rogmark C. Patient-related outcomes after proximal tibial fractures. Int Orthop 2018;42:2925-31. doi: 10.1007/ s00264-018-3920-0, PMID 29627849
Jagdev SS, Pathak SK, Salunke A, Maheshwari P, Ughareja P, Shah S. Functional outcome of schatzker Type V and VI tibial plateau fractures managed with open reduction internal fixation using dual plates. Int J Res Orthop 2017;3:961-5. doi: 10.18203/issn.2455-4510. IntJResOrthop20173215
Prat-Fabregat S, Camacho-Carrasco P. Treatment strategy for tibial plateau fractures: An update. EFORT Open Rev 2016;1:225-32. doi: 10.1302/2058-5241.1.000031, PMID 28461952
Vasiliadis AV, Poutoglidou F, Metaxiotis D, Mpeletsiotis A. Mid-term radiological and functional outcomes of bicondylar tibial plateau fractures managed with open reduction and internal fixation using dual plates. Sultan Qaboos Univ Med J 2022;22:51-7.
Ahearn N, Oppy A, Halliday R, Rowett-Harris J, Morris SA, Chesser TJ, et al. The outcome following fixation of bicondylar tibial plateau fractures. Bone Joint J 2014;96-B:956-62. doi: 10.1302/0301-620X.96B7.32837, PMID 24986951
Canadian Orthopaedic Trauma Society. Open reduction and internal fixation compared with circular fixator application for bicondylar tibial plateau fractures. Results of a multicenter, prospective, randomized clinical trial. J Bone Joint Surg Am 2006;88:2613-23. doi: 10.2106/ JBJS.E.01416, PMID 17142411
Ochen Y, Peek J, McTague MF, Weaver MJ, van der Velde D, Houwert RM, et al. Long-term outcomes after open reduction and internal fixation of bicondylar tibial plateau fractures. Injury 2020;51:1097-102. doi: 10.1016/j.injury.2020.03.003, PMID 32147141
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;14:200-5. doi: 10.1186/2047-783x-14-5-200, PMID 19541576
Polat B, Gurpinar T, Polat AE, Ozturkmen Y. Factors influencing the functional outcomes of tibia plateau fractures after surgical fixation. Niger J Clin Pract 2019;22:1715-21. doi: 10.4103/njcp.njcp_432_18, PMID 31793479
Shekhar S, Pranjal A. Clinical and radiological evaluation of proximal tibia fracture fixed with variable angle proximal tibial interlocking plate: A prospective observational study. J Orthop Dis Traumatol 2022;5:8-13. doi: 10.4103/jodp.jodp_22_21
Rajappan R, Ravikumar V, Suhail AP. Functional outcome of tibial plateau fractures, schatzker Type V and VI treated surgically with plate osteosynthesis. Natl J Clin Orthop 2018;2:35-46.
Mecharla SS, Poduri VR, Paka VK. A study of surgical management of tibial condylar fractures. Med Pulse Int J Orthop 2018;5:13-5.
Paleti ST, Kumar RN. Assessing the functional and radiological outcome in surgically treated closed tibial plateau fractures in adults: A case series of 40 cases. Int J Orthop Sci 2019;5:472-6. doi: 10.22271/ ortho.2019.v5.i1i.82
Oh CW, Oh JK, Kyung HS, Jeon IH, Park BC, Min WK, et al. Double plating of unstable proximal tibial fractures using minimally invasive percutaneous osteosynthesis technique. Acta Orthop 2006;77:524-30. doi: 10.1080/17453670610012548, PMID 16819697
Published
How to Cite
Issue
Section
Copyright (c) 2022 Lakshmi Narayana M, Nagaraju K
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.
