Management of Tibial Plateau Fractures in a Tertiary Care Hospital

Abstract

Background: The multitude, diversity, and complexity of tibial plateau fractures make them difficult to treat. In theliterature, the indications for non-operative vs operative management differ substantially. Varied surgeons haveadvocated for different treatment procedures, with some advocating for conservative management and others advocatingfor aggressive management.Objectives: To compare the surgical management of tibial plateau fractures with percutaneous CC screw fixation, ORIFwith plating and CC screw fixation and universal mini external fixator.Methods: After the diagnosis of 30 patients has been established, the patient was informed of the fracture and the necessityfor surgery. The consent is obtained, and pre-operative planning is done. The Schatzker classification was used to classifyall Tibial plateau fractures prior to surgery. After a minimum of six months post-surgery, patients were followed upperiodically. The functional outcome of the knee was assessed using the Rasmussen score and the knee society score forall patients who met the inclusion criteria.Results: The average time for tibial plateau fracture union was 18 weeks (range from 18-22 weeks). In majority of thecases, around 50% had union of tibial plateau fracture by 16th weeks, 40% had fracture union by 18th week. 7% had fractureunion by 20th week, 3% had fracture union by 22nd week.Conclusion: PCCS or PF + CC screw fixation can attain near anatomical repair of the articular surface of the tibial plateaufracture. Since they are confined to the pattern of the fracture and its size, each of the three procedures employed to treattibial plateau fractures has its own array of pros and cons.