Results of closed reduction percutaneous screw fixation and open reduction internal fixation in tibial plateau fractures

Abstract

Background: Tibial plateau fractures are common injuries that require anatomic reduction to obtain the best functional results. Advance in mechanization and acceleration of travel has been accompanied by an increase in number and severity of fractures and those of the tibial plateau are not an exception. This fracture constitutes approximately 1% of all fractures. Open reduction and rigid internal fixation for displaced tibial plateau fracture achieves the goals of restoring the anatomic articular congruity and mechanical alignment, while allowing early knee mobilization. Aims and Objectives: To study the results and complications of open reduction and internal fixation by plate osteosynthesis versus closed reduction and percutaneous cannulated screw fixation for tibial plateau fractures. Method: 43 patients with tibial plateau fractures treated either with open reduction and plate osteosynthesis or closed reduction and percutaneous cannulated screw fixation were followed up for a period of 18 months and their functional outcome was assessed according to Modified Delamarter functional scoring system. Results: According to modified Delamater functional score, 90% had excellent to satisfactory result in patients treated with percutaneous screw fixation as compared to 67% in those treated with open reduction internal fixation. In both modalities 9% had poor results due to nonunion. Conclusion: Closed reduction and percutaneous screw fixation for tibial plateau fractures is minimally invasive. It reduces the length of hospital stay and costs, enables early mobilization with minimal instrumentation, and achieves satisfactory outcome as compared to open reduction and plate fixation.