Joshi's external stabilization system versus locked compression plating in the management of tibial plateau fractures: A nonrandomized prospective study

Abstract

Context: Among the myriad treatment options available for tibial plateau fractures, Joshi's external stabilization system (JESS) is one of the established treatment modalities as an external fixation device. Closed reduction has the advantage of biological fixation and preservation of the already jeopardized local blood supply to the bone. Aim: This study was conducted to compare the functional results between locked compression plate and JESS as a fixation method for tibial plateau fractures. Setting and Design: This is a prospective, single-center, and nonrandomized study. Materials and Methods: Fifty patients with tibial plateau fractures were included in the study, who presented to our hospital between January 2016 and December 2018 and were treated alternatively by either plating (Group P) or JESS (Group J). Modified Rasmussen functional score (MRFS) was used for assessing the functional outcomes. Statistical Analysis Used: Microsoft Excel and Statistical software SPSS version 21.0. Results: The mean age in Group J and P was 39.52 ± 9.27 years and 39.00 ± 10.82 years, respectively. The mean follow-up period was 12 months (range: 9–24 months). Schatzker Type II was the most common fracture pattern (n = 15). The average union time was 12.3 weeks in Group J and 14 weeks in Group P (P = 0.036). The mean MRFS at 3, 6, and 9 months of follow-up was significantly better in the J group (P value at 3 months was 0.0204, at 6 months was 0.0226, and at 9 months was 0.0048). Conclusion: The study shows that the functional outcome of JESS for the management of tibial plateau fractures is better than plating.