FUNCTIONAL OUTCOMES OF MANAGEMENT OF TIBIAL PLATEAU FRACTURES (TYPE II) BY CLOSED REDUCTION AND PERCUTANEOUS SCREWS

Abstract

To evaluate the outcomes of closed reduction and percutaneous screw fixation for tibial plateau fractures (Type II). 9 men and 3 women aged 21 to 64 (mean, 38.1) years underwent closed reduction and percutaneous screw fixation for closed tibial plateau fractures (type II) according to the Schatzker classification. Closed reduction was achieved using manual ligamentotaxis with traction in extension under image intensifier control. Reduction was fixed percutaneously with cancellous screws (6.5 mm) and washers. Functional outcome (pain, walking capacity, extension lag, range of motion, stability and return to daily activity) was evaluated using the Modified Hospital for Special Surgery Score. A total score of 55 to 60 was considered as excellent, 45 to 54 as good, 35 to 44 as fair, and <35 as poor. Patients were followed up for a mean of 8 (range, 6-12) months. The mean length of hospital stay was 2 (range, 1-3) days. All the fractures united radiographically after a mean of 3 (range, 2.5-3.5) months. The score was excellent in 4 patients, good in 6 patients, and fair in 2 patients. The mean Modified-HSS score was 53.3. No patient had infection or wound dehiscence. Closed reduction and percutaneous screw fixation for tibial plateau fractures (type II) is a minimally invasive method of fixation that reduces the length of hospital stay and costs, enables early mobilization with minimal instrumentation, and achieves satisfactory outcomes.