Comparative study of fixation of proximal tibial fractures by nonlocking buttress versus locking compression plate

Abstract

Background: Management of tibial plate fracture represents a challenging problem in developing countries. Aims: To compare the results of treatment of tibial plateau fractures with conventional nonlocking buttress plates (BP group) and locking compression plates (LCPs). Materials and Methods: The study was conducted on 30 patients with intra-articular closed fractures of the proximal tibia who were alternately assigned to two different treatment protocol, conventional nonlocking BP group or locking plates (LP group). Results : Schatzker Type II fracture was found to be the commonest fracture type with 13 patients. Only lateral plating was done in 24 patients, and dual plating was done in 6 patients. In 8 patients, corticocancellous bone graft were used. On follow-up complications like superficial skin necrosis (two cases), infection (two cases), varus collapse (three cases) developed. Sixty percent in LCP group, 66.6% in buttress group fractures clinically united in the time period of 7-9 weeks and 73.3% in LCP group and 80% in buttress group radiological union occurred in a period of 12-15 weeks. The results were graded in accordance with Poul S. Rasmussen's grading system. During the follow-up, 73.3% in LCP group and 66.6% in buttress group had no pain after clinical union. 66.6% patients in LCP group and 73.3% in buttress group could perform normal walking. About 86.6%in each group had no lack of extension. Nine patients (60%) in LCP group and 10 patients (66.6%) had flexion of up to at least 140°. About 86.6% in LCP group and 80% in buttress group had a stable joint in extension. Conclusion: Considering its high cost, LP group should only be used, where it is more advantageous than conventional plate.