ANALYSIS OF THE FUNCTIONAL AND RADIOLOGICAL OUTCOME OF TIBIAL PLATEAU FRACTURES TREATED BY OPEN REDUCTION INTERNAL FIXATION WITH LOCKING COMPRESSION PLATE BASED ON 3D CT THREE COLUMN FOUR SEGMENT SPECIFIC FIXATION - A PROSPECTIVE STUDY

Abstract

Introduction: Tibial plateau fractures are caused by high-energy trauma. Historically, the Schatzker and AO/OTA classication systems are widely used, In 2010 Luo et al in china has developed Three-Column Four segment specific fixation for complex Tibial plateau fractures. Aim & Objective: To analyse the functional outcome and radiological outcome of Tibial plateau fractures treated by Open Reduction Internal Fixation (ORIF) with Locking Compression Plate (LCP) based on Three-Column Four segment specic xation. Materials and Methods: This is a prospective study of 33 patients with Tibial plateau fractures with column specic involvement based on preoperative CT were selected for the study after getting ethical clearance in duration from Dec 2019 to June 2021. Outcome of surgery was evaluated using knee society scoring system and Modied Rasmussen Radiological Assessment criteria. Results: In our study we had all 100% study population (33 patients) had RTA as mode of injury with male predominance of 81% with age range of 20–60. In this, 73% had more than one column fracture. 2 patients temporarily stabilized with external xation while others with above knee slab, then denitive management by column specic xation by ORIF with LCP. We achieved union in all cases within range of 10-15 weeks of post operative period with few complications. We allowed full weight bearing after clinical and radiological signs of union at an average of 12-14 weeks. About 85% had good functional range of movements and able to perform their daily activities. Conclusion: Column based concept makes the surgeon to prepare better for the choice in approach, implant selection and column specic xation which gives better biomechanical strength and rigid construct than unilateral plating. Early joint mobilization and weight bearing was started around 2-3 months and contributes to better nal knee range of motion.