The comparison of clinical effect, knee function, prognosis of double plate fixation and locking plate internal fixation for tibial plateau fractures.

Qing Zhang,Jianzhong Zhao,Guangcheng Zhang,Mingjun Nie,Jiazhu Tang,Wei Zhu

doi:10.12669/pjms.38.4.5340

Abstract

Objectives:The purpose of this study was to investigate the clinical effect, knee function improvement and prognosis of double plate internal fixation and locking plate internal fixation in the treatment of tibial plateau fractures.Methods:Clinical data from 96 tibial plateau fracture patients treated at our hospital were analyzed retrospectively. Of these, 46 had been treated using locking plate internal fixation and 50 were treated with double T-shaped plate fixation. Clinically related indices, Hospital for Special Surgery (HSS) score of knee function, and ability of daily living (ADL) score were evaluated during postoperative follow-up.Results:No significant differences were observed in pre-operative patient characteristics in both groups. Healing time, time to weight-bearing, tibial plateau angle (TPA) and lateral posterior angle (PA) were all superior in the locking plate fixation group compared to the double plate fixation group. At three months post-operative visit, range of motion, knee function, flexion deformity, muscle strength, pain, and stability metrics were all superior in the locking plate fixation group compared to the double plate fixation group. ADL scores were also higher in the locking plate fixation group than in the double plate fixation group at three and six months follow-up.Conclusions:The clinical effect, knee function improvement and prognosis of locking plate internal fixation in the treatment of tibial plateau fractures are better than those of double plate fixation.

Highlights

Tibial plateau fractures are mainly caused by high-energy injury.[1]
Three months after the operation, the Hospital for Special Surgery (HSS) score in the locking plate internal fixation group were significantly higher than those in the double plate fixation group (P < 0.05) (Table-IV), There was no significant difference in ability of daily living (ADL) score between the two groups before the operation (P > 0.05); the ADL scores of locking plate fixation group were significantly higher than those of double plate fixation group at 3 and 6 months after the operation (P < 0.05) (Table-V)
This study showed that locking plate and double plate internal fixations have achieved good results in the treatment of tibial plateau fractures

Summary

Introduction

Tibial plateau fractures are mainly caused by high-energy injury.[1]. The severe comminution of the articular surface often results in the involvement of the epiphysis or shaft of the tibial shaft, and may result in soft tissue injury, creating a more complex fracture situation.[2]. Tibial plateau fracture may lead to significant changes in the tibial morphology, such as collapse, splitting, compression, and similar phenomena.[3]. The main method for the treatment of tibial plateau fractures is surgery. Pak J Med Sci March - April 2022 (Part-II) Vol 38 No 4 www.pjms.org.pk 960 locking plate internal fixation are commonly used in clinic.[4]. Which of the two methods is more efficacious is unclear. This study analyzed clinical data to examine the respective clinical efficacies of these two techniques, as well as their impacts on knee joint function and prognosis

Objectives

Methods

Results

Conclusion