Necessity of dual plating in bicondylar tibial plateau fracture dislocations: A prospective case series

Abstract

Background: Management of bicondylar tibial plateau fracture dislocations is a serious challenge in terms of soft-tissue complications, fracture morphology, early mobilization, and maintenance of alignment and reduction postoperatively. We have conducted a prospective study to evaluate the necessity of dual plating in these fractures to achieve articular reduction, early mobilization, and maintenance of alignment on long-term follow-up. Materials and Methods: A prospective study including 24 patients with bicondylar tibial plateau fracture dislocations were operated with dual plating through dual-incision approach. Patients were evaluated clinically and radiologically for a minimum period of 24 months. All patients were operated after a minimum period of 7 days, to prevent soft-tissue complications. Functional evaluation was done using Oxford knee score. Results: A total of 24 patients were operated with dual plating, including 20 males and 4 females with the mean age of 36 years. All cases united with mean healing time of 15.2 weeks, malunion was seen in one case. Functional outcome was assessed using Oxford knee score which was excellent in 21 cases (87.5%) and good in 3 cases (12.5%). Conclusion: Dual plating for bicondylar tibial plateau fracture dislocations is necessary to achieve articular congruity, stable fixation, early mobilization, and maintenance of limb alignment on long-term follow-up. The only concern is soft-tissue complications which can be minimized by waiting for adequate time preoperatively and meticulous surgical technique.