Evaluation of operative results of displaced tibial plateau fractures

Abstract

Objective The aim of this study was to evaluate knee function in patients with displaced tibial plateau fractures treated with open reduction internal fixation and minimally invasive percutaneous plate osteosynthesis techniques. Background Proximal tibial fracture is a common injury; these fractures represent surgical challenge because of the variety of fracture patterns and the associated soft tissue injuries. If not adequately treated, these fractures often cause persistent knee pain, arthritis, stiffness, and angular deformity. Patients and methods This prospective study was conducted on 30 tibial plateau fractures in 30 patients who were functionally and radiologically evaluated according to the knee scoring system. The cases were managed with open reduction and internal fixation with plate and screws and using minimally invasive percutaneous plate osteosynthesis. The entire limb (except the foot) and the ipsilateral iliac crest were prepped and draped into the surgical field under complete aseptic technique. Results In this study, the majority of fractures occurred between the ages of 26 and 44 years with a mean ± SD of 37.6 ± 4.7 years, and the majority of fractures were found to be of type V (23.3%) and type VI (23.3%) according to the Schatzeker classification. In this study, we had 27 (90%) patients with no complications and three (10%) patients with infection who were treated with open reduction internal fixation. In this study according to Oxford and International Knee Documentation Committee knee scores, there was a highly significant difference between results after 1, 3, and 6 months. The end results were as follows: 59.3%, excellent; 37%, good; and 3.7%, fair. Conclusion Tibial plateau fractures occur due to high-energy trauma. The minimally invasive plate osteosynthesis technique is a good method for the treatment of tibial plateau fractures and it results in good clinical and functional outcome. The functional results of this fracture improve with time, reaching the maximum by 6 months. Despite anatomical joint reconstruction, development of osteoarthritis may still occur secondary to the initial articular cartilage and meniscal injury.