Outcome Of Tibial Plateau Fractures Research Articles

A Prospective Study of Functional Outcome of Tibial Plateau Fracture Treated with Locking Compression Plate

A Prospective Study of Functional Outcome of Tibial Plateau Fracture Treated with Locking Compression Plate

The Clinicoradiological Outcome of Arthroscopic-assisted Reduction and Internal Fixation of Tibial Plateau Fractures

Abstract Background: The fractures of the tibial plateau are intraarticular fractures accounting for 1% of all fractures. Surgical management of such fractures is often challenging because they require anatomical reduction and stable fixation, which will allow for early rehabilitation. Arthroscopy has evolved nowadays and arthroscopically assisted reduction and fixation is a good option among the available surgical options. Materials and Methods: This prospective study included 50 cases of tibial plateau fractures managed surgically by arthroscopic-assisted reduction and fixation starting from August 2019 to December 2022. Results: The patients were 39 years old on average and were mostly men (58%). The right knee was the most usually injured (53%), and the most common cause of injury (41.5%) was a fall from a height. The majority of these fractures (44.5%) belonged to Schatzker type 2, followed by type 1 (37%) and type 3 (18.5%). The average time to complete weight-bearing for a Schatzker type I fracture was 10 weeks, 11.5 weeks for a type II fracture, and 13.5 weeks for a type III fracture. The average time to union for Schatzker type I was 13 weeks, 15.5 weeks for type II, and 16 weeks for type III. The mean clinical and radiological scores using the modified Rasmussen criteria were 26.3 and 7.3, respectively. Conclusions: A good surgical outcome of tibial plateau fracture is acquired when anatomic articular surface reconstruction with the elevation of depressed bone fragment is combined with rigid stable fixation, which permits early rehabilitation. Arthroscopy helps in achieving these goals by providing a good visualization of the articular surfaces, adequate fracture reduction, and anatomical restoration of the joint surface and aids in thorough joint lavage to remove the intraarticular debris.

Efficacy of Cal-Cemex as bone substitute for tibial plateau fractures

BackgroundVarious factors influence treatment and outcomes in tibial plateau fractures. Bone defects are among them. Many materials have been proposed to address this problem: allograft, bone–cements and various bone substitutes (BSM). Cal-Cemex (β-tricalciophosphate and polymethylmethacrylate) is a new hybrid bi-component BSM. A retrospective multicenter study was conducted based on the clinical experience of three European Hospitals, to demonstrate its clinical effectiveness, versatility and safety.Materials and MethodsFrom December 2016 to March 2022, 45 displaced tibial plateau fractures were treated with internal fixation and augmentation using Cal-Cemex. The average age was 55.9 years. According to Schatzker classification, we included 13 type II, 24 type III, 3 type V and 4 type VI fractures. The postoperative follow-up (FU) consisted of clinical and radiological examinations at 6 and 12 weeks and 1 year after surgery. A CT scan was performed preoperatively and 1 year after surgery. Full weight bearing was permitted after less than 6 weeks. Clinical data were collected from patient charts, while functional data were evaluated using the Rasmussen knee function score, the KOOS score and the Hospital for Special Surgery knee rating score (HSS), to evaluate the range of motion, axis and functionality of the knee.ResultsThe average FU was 42.8 months. CT scans taken at 1 year demonstrated a good surface osteointegration without radiolucent lines or osteolysis with good evidence of interdigitation and even bone ingrowth. At 1-year FU, the mean Rasmussen score was 24.7, the mean KOOS score was 90.7 and the mean HSS was 89.9 and the average full weight-bearing period 34.9. No patients had hardware failure or fracture secondary displacement.DiscussionCal-Cemex combines biological features and good mechanical performances. It guarantees biocompatibility and osteoconductivity, although it is not fully reabsorbable; β-tricalciophosphate component gives macro- and microporosity that allow fluids to penetrate inside the material, to stimulate bone ingrowth.ConclusionsThe study suggests that Cal-Cemex is an option for tibial plateau fractures, where augmentation and support are necessary for early full weight bearing. The absence of major complications, ease of application, the possibility to cut and perforate this material support its extensive use in bone augmentation for trauma cases.

Analysis of regional features of the tibial plateau fractures in the Rostov region

Background. The prevalence of tibial plateau fractures reaches 51.7 per 100,000 population per year, accounting for approximately 1% of all fractures, and is associated with the development of post-traumatic knee osteoarthritis in 25-45% of cases.
 The aim of this study was to investigate the regional features, including frequency, structure, and outcomes, of S82.1 fractures.
 Methods. An anonymized sample was obtained from the regions database, covering the period from 2017 to 2021, using the ICD-10 codes S82.1, Z47.0, M17.2, and M17.3. Data Science principles and software were applied for analysis.
 Results. A total of 14,705 records were obtained. The average prevalence of tibial plateau fractures in the region was 24 per 100,000 population per year. The frequency of fractures was highest among the working-age population, with a male-to-female ratio of 1.02:1.00. There was a shift in the age group of knee osteoarthritis occurrence to individuals over 60 years old. Since 2018, a decrease in the number of fractures has been observed among elderly individuals. Out of the total sample, 1,017 patients were hospitalized, and 1,752 operations were performed. Open injuries accounted for 1.9% of cases, and the complication rate was 5.3%. Moderate correlations were found between open fractures, complicated course, and inpatient treatment costs (0.42r0.3). The probability of developing knee osteoarthritis within a five-year period was 0.0161. The average age of men with knee osteoarthritis was 517 years, while for women, it was 607 years. The younger age of osteoarthritis onset in men may be associated with a higher prevalence of severe fractures. The average cost of inpatient treatment increased from 26,533 rubles in 2017 to 34,682 rubles in 2021, significantly exceeding the cost of outpatient treatment.
 Conclusion. Tibial plateau fractures (S82.1) predominantly occur among economically active men. The decrease in the proportion of elderly individuals with fractures in the years 2019-2021 may be explained by a decrease in the elderly population in the region and the impact of pandemic-related restrictions. The compulsory health insurance system incurs the highest costs during inpatient care. It is advisable to include classification features of fractures according to the OA/OTA system in databases to facilitate more accurate planning and differentiation of treatment expenses.

Implementing 3D fluoroscopy in the management of tibial plateau fractures: Shorter hospitalization and decline in revision surgery, but increase in the duration of surgery and radiation exposure

BackgroundIntraoperative 3D fluoroscopy (3DRX) is increasingly used in fracture management instead of conventional fluoroscopy (RX), but its effect on the treatment and outcome of tibial plateau fractures (TFs) is not well known. This study aims to evaluate whether the use of 3DRX in the treatment of tibial plateau fractures reduces the number of revision surgeries. MethodsThis retrospective cohort study includes all patients who underwent surgical treatment for TF in a single center from 2014 to 2018. Patient-, fracture-, and treatment characteristics were compared between the 3DRX and RX subgroups. The primary endpoint was the number of patients requiring revision surgery. Secondary endpoints were surgery duration, hospital length of stay, radiation exposure, postoperative complications, and secondary total knee arthroplasty. ResultsEighty-seven patients were included, of which 36 were treated with 3DRX. Three patients in the RX group required revision surgery, while no revision surgery was performed in the 3DRX group (p = 0.265). The use of 3DRX resulted in significantly more intraoperative adjustments (25% versus 6%; p = 0.024) and an increase in surgery duration (by average of 28 min, p = 0.001), without a significant increase in postoperative wound infections (12% versus 19%; p = 0.374) or fracture-related infections (2% versus 2.8%; p = 0.802). The 3DRX group had an average radiation exposure of 7,985 mGy versus 1,273 mGy in the RX group (p<0.001). The hospital length of stay was 1 day shorter in the 3DRX group (5 days versus 4 days; p = 0.058). ConclusionsImplementing 3DRX in treating TFs improves the assessment of fracture alignment and implant position perioperatively, resulting in more intraoperative corrections and no revision surgeries within 6 weeks postoperatively. However, using 3DRX significantly increases perioperative radiation exposure and surgery duration without a significant rise in postoperative infections and a shorter hospital length of stay.

Corrigendum to ‘Epidemiology and outcomes of tibial plateau fractures in adults aged 60 and over treated in the United Kingdom’ [Injury Volume 53 Issue 6 (2022) Pages 2219-2225

Corrigendum to ‘Epidemiology and outcomes of tibial plateau fractures in adults aged 60 and over treated in the United Kingdom’ [Injury Volume 53 Issue 6 (2022) Pages 2219-2225

Outcome of Newer Generation Implant Reducing Post-Operative Co-Morbidity in All Kinds of Tibial Plateau Fracture; An Observational Study

Background: Fractures of the tibial plateau, which are intra-articular injuries of the knee joint, are often difficult to treat and have a high complication rate, including early-onset osteoarthritis. Various treatment options including proximal tibial plating with locking compression plates are available for the treatment of tibial plateau fracture. Objective: The purpose of this research was to evaluate the functional outcome of tibial plateau fractures treated with locking compression plating; a technique found to effectively reduce post-operative co-morbidities. Material and Methods: This prospective and observational study was carried out in Multicentral base with Department of Orthopedic Surgery, Rajshahi Medical College, Rajshahi, Bangladesh from January 2020 to June 2022. All patients (n=256) enrolled in the study for the study were included and treated with a locking compression plate for tibial plateau fractures (Schatzker III-VI) after receiving informed written permission. Patients were monitored continuously with clinically, radiographically, and functionally at 6-weeks and 3-6 Month, fellow-up after surgery. Results: In our study of 256 cases, the mean age was 37.77 ±15.65 years. Most of the cases were Schatzker type VI (161 patients) 63% and type III (89 patients) 35%. The average duration for fractures union was 23.4 ±2.1 weeks. Superficial wound infection was the common complication seen in (6 patient) 2% cases. At six months, the mean knee society score (KSS) was 85 ±7.22 and majority of patients (245 patients) 95% had good results. Conclusion: The radiological and functional outcome of a locking compression plate is quite excellent. Tibial plateau fractures in adults can be effectively treated with this implant.

FUNCTIONAL AND RADIOLOGICAL OUTCOME OF TIBIAL PLATEAU FRACTURES MANAGED WITH INTERNAL FIXATION

Objectives: Tibial plateau fractures constitute a wide spectrum of severity from simple to complex fracture patterns. Treatment methods such as internal fixation and hybrid external fixation are commonly administered with specific limitations. The present study was designed to evaluate radiological and functional outcome of tibial plateau fractures managed with internal fixation. Methods: Thirty-six cases with tibial plateau fractures above 21 years were recruited. All the study cases were managed with open reduction and internal fixation. The post-operative follow-up was continued till 6 months with proper clinicoradiological evaluation to check range of motion, reduction loss, and fracture union. The functional outcome was assessed by Oxford Knee Society score and operative outcome was assessed by modified Rasmussen clinical and radiological criteria. Results: Functional outcome assessed by Oxford Knee Society score showed both excellent and good outcomes in 91.67% of cases cumulatively. Clinical outcome by modified Rasmussen assessment criteria reported excellent outcome in 33.33%, good in 44.44%, fair in 13.88%, and poor in 8.33%. Radiological outcome was excellent in 16.6%, good in 63.88%, fair in 11.11%, and poor in 8.33%. Conclusion: The post-operative functional, clinical, and radiological outcomes indicate that open or closed reduction and internal fixation had gained excellent results and are effective modalities in the management of tibial plateau fractures.

Radiographic and clinical outcome of tibial plateau fractures treated with bone allograft

BackgroundTo determine the clinical outcome of patients who had been treated with bone allografts during open reduction and internal fixation (ORIF) of tibial head fractures.MethodsPatients who suffered a medial, lateral, or bicondylar fracture of the tibial plateau and underwent surgical treatment by open reduction and internal fixation (ORIF) using human femoral head bone allografts were included. Patients were invited to provide information for the following: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EuroQol Five Dimension score (EQ-5D), Lower Extremity Functional Scale (LEFS) and Parker Mobility Score. Bone mineral density (BMD) of the allograft area and the healthy human bone tissue were measured by quantitative computed tomography.ResultsA total of 22 patients with a mean follow-up time of 2.88 ± 2.46 years were included in our study. The most common fractures observed in this study were classified as Schatzker II (11 patients, 50.0%) or AO/OTA 41.B3 (12 patients, 54.5%) fractures. Postoperative WOMAC total was 13.0 (IQR = 16.3, range 0–33). Median quality of life (EQ-5D) score was 0.887 ± 0.121 (range 0.361–1.000). Median Lower Extremity Functional Scale (LEFS) score was 57.5 ± 19.0 (range 33–79). Mean Parker Mobility Score was 9 (range 6–9). Median bone mineral density (BMD) for the whole group was 300.04 ± 226.02 mg/cm3 (range − 88.68 to 555.06 mg/cm3) for region of interest (ROI 5) (central), 214.80 ± 167.45 mg/cm3 (range − 7.16 to 597.21 mg/cm3) for ROI 1–4 (marginal zones: medial, lateral, ventral, dorsal) and 168.14 ± 65.54 mg/cm3 (range 17.47–208.97 mg/cm3) for healthy bone tissue (femur and tibia).ConclusionBased on WOMAC scores, LEFS, ambulatory status, and quality of life findings, it can be concluded that following tibial head ORIF with allograft bone patients has promising results.

Assessment of intra-articular tibial plateau fractures by the three-dimensional revised Schatzker classification: Study of 94 cases

Background: The functional outcome of tibial plateau fractures depends a lot on stable osteosynthesis. It require an exact knowledge of the spatial configuration of the fracture. Our objective is to describe fracture plane base on computer tomography. Methods: We used Schatzker's three-dimensional classification to analyze computed tomography of patients admitted for tibial plateau fractures at the University Hospital Center of Oujda between January 2012 and August 2020. Results: We found 94 fractures, mostly type II and VI with 3 unclassifiable fractures. The anterolateral compartment is the most often affected. The overall tibial plateau coronal fracture lines was 14.89% and is most common among type IV. Conclusion: Characterization of complex tibial plateau fractures with use of the main shear presented in this study may be more reliable for communication among surgeons, comparison of studies, preoperative planning and guiding the surgical approach and specific fixation techniques.

Clinical and radiological significance of posteromedial fragment in tibial plateau fractures

IntroductionThe effect of joint fragmentation, especially the posteromedial fragment, on treatment outcomes in tibial plateau fractures has been better understood in recent years. In this study, we wanted to examine whether the accompanying posteromedial fragment has an effect on clinical and radiological results. Patients and methodsPatients who underwent open reduction and internal fixation with plate and screw due to tibial plateau fracture were retrospectively screened. The patients were divided into two groups as with and without posteromedial fragment. Clinical, radiological and complications were compared statistically. Results38 out of 52 patients were included in the study. The mean age of the patients was 46.08, 26 (68.42%) were female and 12 (31.58%) were male. Mean follow-up was 18.55 months. Posteromedial fragment was present in 21 (55.6%) patients, but not in 17 (44.4%) patients. When the two groups were compared according to the Rasmussen clinical and radiological criteria, no statistically significant difference was found. There was no statistically significant difference between the two groups in the rates of infection, non-union, malunion, joint separation, early arthrosis and arthrofibrosis (p > 0.05). A statistically significant difference was found between the two groups in terms of reduction loss rates (p < 0.05). ConclusionsThe accompanying tibial plateau fractures of the posteromedial fragment are characteristic fractures. Care should be taken to maintain the stability of the fracture fixation.

ANALYSIS OF THE FUNCTIONAL AND RADIOLOGICAL OUTCOME OF TIBIAL PLATEAU FRACTURES TREATED BY OPEN REDUCTION INTERNAL FIXATION WITH LOCKING COMPRESSION PLATE BASED ON 3D CT THREE COLUMN FOUR SEGMENT SPECIFIC FIXATION - A PROSPECTIVE STUDY

Introduction: Tibial plateau fractures are caused by high-energy trauma. Historically, the Schatzker and AO/OTA classication systems are widely used, In 2010 Luo et al in china has developed Three-Column Four segment specific fixation for complex Tibial plateau fractures. Aim &amp; Objective: To analyse the functional outcome and radiological outcome of Tibial plateau fractures treated by Open Reduction Internal Fixation (ORIF) with Locking Compression Plate (LCP) based on Three-Column Four segment specic xation. Materials and Methods: This is a prospective study of 33 patients with Tibial plateau fractures with column specic involvement based on preoperative CT were selected for the study after getting ethical clearance in duration from Dec 2019 to June 2021. Outcome of surgery was evaluated using knee society scoring system and Modied Rasmussen Radiological Assessment criteria. Results: In our study we had all 100% study population (33 patients) had RTA as mode of injury with male predominance of 81% with age range of 20–60. In this, 73% had more than one column fracture. 2 patients temporarily stabilized with external xation while others with above knee slab, then denitive management by column specic xation by ORIF with LCP. We achieved union in all cases within range of 10-15 weeks of post operative period with few complications. We allowed full weight bearing after clinical and radiological signs of union at an average of 12-14 weeks. About 85% had good functional range of movements and able to perform their daily activities. Conclusion: Column based concept makes the surgeon to prepare better for the choice in approach, implant selection and column specic xation which gives better biomechanical strength and rigid construct than unilateral plating. Early joint mobilization and weight bearing was started around 2-3 months and contributes to better nal knee range of motion.

Epidemiology and outcomes of tibial plateau fractures in adults aged 60 and over treated in the United Kingdom

BackgroundTibial plateau fractures are common in older adults, often resulting from low-energy falls. Although lower limb fragility fracture care has evolved, the management of tibial plateau fractures in older patients remains poorly researched. This study aimed to define the epidemiology, treatment and outcomes of tibial plateau fractures in patients aged over 60 years. MethodologyPatients aged 60 years or older with a tibial plateau fracture who presented to a single trauma center between January 2008 and December 2018 were identified. Incomplete records were excluded. Epidemiological data, fracture classification, injury management, radiological outcomes, complications, and mortality were assessed via retrospective case note and radiograph review. Local ethics approval was obtained. ResultsTwo-hundred and twenty patients with a mean age of 74 years (range 60–100) were included. 73% were female and 71% of injuries were sustained following low-energy falls. Median follow up was three months. 50% of fractures involved the lateral plateau. 60% of injuries were treated non-operatively. 76% of patients had their weight-bearing restricted for the first six weeks, with little difference between operatively and non-operatively managed patients. 8% of all patients required subsequent knee replacement. All-cause mortality at 30-days and one-year were 2% and 5% respectively. ConclusionThe majority of tibial plateau fractures in the over 60s are sustained from low-energy trauma. Management is relatively conservative when compared with younger cohorts. The data reported brings up questions of whether surgical treatment is beneficial to this patient group, or whether restricted weight bearing is either possible or beneficial. Prospective, multi-center comparative trials are needed to determine whether increased operative intervention or different rehabilitation strategies purveys any patient benefit.

Mid-Term Radiological and Functional Outcomes of Bicondylar Tibial Plateau Fractures Managed with Open Reduction and Internal Fixation Using Dual Plates.

ObjectivesThis study aimed to evaluate the mid-term radiological and functional outcome of tibial plateau fractures treated by plating.MethodsThis study was conducted at the General Hospital of Thessaloniki ‘Papageorgiou’, Thessaloniki, Greece. Patients with Schatzker type V and VI tibial plateau fractures who were managed with open reduction and internal fixation using dual plates between January 2011 and December 2018 were included in this retrospective study. The functional evaluation of the patients was carried out with the visual analogue scale (VAS), the health-related quality of life status was measured using the Short Form-36 and the dimensions of pain, stiffness and function were assessed using the Western Ontario and McMaster Universities Arthritis Index. For the radiological outcome evaluation, the modified Rasmussen criteria were used.ResultsFifty-seven patients (30 male and 27 female) were included in the study with a mean follow-up of 50.88 months. There were 23 Schatzker type V and 34 type VI fractures. The majority of patients (86%) had a good to excellent radiological outcome. The mean VAS score was 1.65 for all the patients. The functional outcome was excellent in the majority of the patients. Among them, 5.3% (n = 3) suffered wound infection and all wounds healed after different treatments. All patients returned to their pre-injury activities of daily living and employment status, while 53% of the patients returned to sporting activities.ConclusionThe findings support previous literature which has demonstrated that bicondylar tibial plateau fractures can provide good-to-excellent radiological and functional outcomes if they are treated with open reduction and internal fixation with dual plating.

Study of functional outcome of tibial plateau fractures treated with anatomical contoured locking compression plate

Tibial plateau fractures tend to occur in patients with polytrauma and in elderly patients with history of significant fall. This study was undertaken to evaluate and explore new generation implant fixation in tibial plateau fractures which is expected to provide a stable fixation with minimum exposure, early mobilization, less complications and a better quality of life.About 43 cases who had sustained tibial plateau fractures (Schatzker type I-VI) and operated with anatomical contoured locking compression plate were included. Follow-up of these patients was done at 6 weeks, 3 months, and 6 months after surgery. We analyzed all our subjects using IKDC score for functional outcome and plateau depression measurement for radiological outcome at 3 months and 6 months.All the 43 fractures analysed in this study were graded in accordance to the Schatzker classification. It was observed that most of these fractures, i.e., 16 out of 43 (37.2%) were type VI and 13 out of 43 (30.2%) type V. The average knee flexion at 3 months was 105.7±8.49 degrees and at 6 months 120.6±8.61 degrees. After evaluation, it was observed that at 6 months, 3 patients had extension lag (7%) out total 43 patients. Most of the patients had average IKDC score of 80.2±7.91% at 3 months which increased to average 86.92±8.05% at 6 months.Achieving and maintaining anatomical reduction becomes easy with advanced design of these plates, which helps in early mobilization and hence obtaining good functional and radiological outcomes of tibial plateau fractures.

Functional outcome of tibial plateau fractures treated by Locking Compression Plates- A Prospective Study.

Introduction: Tibial plateau fractures represent the fractures involving the articular surface of proximal part of the tibia bone i.e. lateral or medial condyle or both, and with varying degrees of articular depression and displacement.Fixation by locking plates has led to dramatic improvement in the treatment of tibial plateau fractures. Method: It was a prospective study conducted on 30 patients with tibial plateau fractures at a tertiary care hospital in New Delhi, India. Patients were operated with locking compression plates and followed up for 18 months. Union was checked with serial radiographs and functional outcome was assessed with Rasmussen Functional Knee Score. Result:Twentynine patients achieved union at a mean time of 13.65 weeks, one patient had infective nonunion. Overall mean Rasmussen Functional Knee Score was 27 which is graded as excellent. Conclusion: Treatment of tibial plateau fractures with open reduction and plating with locking compression plates provides anatomical reduction and desirable functional outcome. Union is earlier and functional results are better for Schatzker type 1-3 when compared to type 4-6. Return to work with greater capacity largely depends on motivation.

Importance of CT Scan in Predicting the Outcomes of Tibial Plateau Fractures: A Retrospective Study of 216 Patients over 10 Years’ Time

The primary aim of this retrospective study was to assess the postoperative clinical, functional, and radiographic outcomes of patients with closed tibial plateau fractures (TPFs) surgically treated with proximal tibial locking compression plate (LCP) system with a focus on the use of preoperative CT scan. Two hundred and sixteen patients with TPFs who underwent surgical treatment in our department between January 2010 and December 2019 were enrolled in this study. Ninety-five patients of 216 (44.0%) had preoperative CT examination in addition to plain radiographs to better evaluate the pattern of fracture and displacement of fragments. Clinical and functional outcomes were assessed using VAS, SF-36, Knee Society Score (KSS) and WOMAC score. Radiographic outcomes were evaluated according to the Kellgreen- Lawrence classification of the pre- and postoperative grades of valgus knee, articular displacement and gonarthrosis. Patients with preoperative CT showed better clinical results than the X-ray group for the VAS, KSS, WOMAC and SF-36 score. Moreover, we found that the X-ray group had worse results than the CT group in the rate of varus-valgus alignment and step-off worsening, while the posterior tibial slope showed no significant changes between the two groups at the final follow-up. Finally, the group of patients who received preoperative CT scans displayed a better immediate postoperative reduction and less long-term arthritis. CT has proved to be a good examination in preoperative planning of TPFs: it can influence postoperative results thanks to an improvement in the surgical approach, a better evaluation of the morphology of fracture lines and the involvement of the Luo's three columns in axial CT scans.

A prospective study of management of tibial plateau fractures by locking compression plate in adults

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Tibial plateau fractures are one of the most complex and disabling fractures of the knee. The tibial plateau is important in transmitting load through the knee. These fractures need a meticulous management protocol in order to minimize patient's disability in range of movement, stability and reducing the risk of documented complications. The aim of the present study is to study the outcome of tibial plateau fractures managed with a locked compression plate.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This study was conducted at a tertiary-care medical college and hospital, Aurangabad specializing in post-graduate training, where all patients who underwent surgical treatment between September 2018 and October 2020 were included. Patients were assessed using the knee society score (KSS). These evaluations were done at 1, 3, 6, 9 and 12 months.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; In our study we included 55 patients out of which we found union in 98% of patients with 83% of patients showing good flexion at knee joint (&amp;gt;110 degrees). 85% patients achieved union within 6 months. An excellent KSS grade was seen in 38.2% patients with another 43.6% showing good outcome. 4 patients showed infection and 1 showed non-union. A single case of malunion was seen in our study.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Locked compression plates in tibial plateau fractures has revolutionized the way these fractures are managed. Anatomic reduction is of utmost importance. Early physiotherapy which plays key role in preventing knee stiffness, use of bone grafts and good fixation are important for successful outcome.&lt;/p&gt;

Functional outcome of tibial plateau fractures treated with locking and non locking plate fixation: A retrospective study

Tibial plateau fracture have been a challenge to treat as these fractures are associated with severe damage to the soft tissue envelope and significant communition and bone loss. This may be due to high speed velocity accidents or fall from height. There exist no gold standard approach in treating these fractures, each case may vary in terms of soft tissue injury, communition and association of neurovascular status. This study was conducted by department of orthopaedics at Government Medical College Ernakulam from February 2018 to January 2020, during this period 30 patients managed by internal fixation was evaluated for their functional outcome. The patients were assigned into two groups; those treated with locking plate and another being the Non locking group. Follow up range was 10-24 months, average being 17.4.This study revealed locking plates to be superior in terms of knee scores, radiological outcomes and post-operative pain.

Dual plate osteosynthesis in bicondylar tibial plateau fractures-case series

&lt;p&gt;Tibial plateau fractures accounts for about 1% of injuries. Various mechanisms have been described, resulting in milder form to serious injuries depending upon force of impact. High velocity injuries resulted from valgus or varus impacted forces combined with axial loading such as in Schatzker type 6. The ideal method of treatment for these fractures is always a matter of debate. As all intra-articular fractures necessitate anatomic reduction of the articular surface, restoration of axial alignment, and stable fixation, which can be achieved very well by open reduction and internal fixation (ORIF) with dual plating. To study the functional and radiological outcome of Tibial plateau fractures treated surgically with dual plate osteosynthesis. 15 patients in the age group 18-60 were included. Rasmussens criteria was used to assess the functional and radiological outcomes with follow up period of 1 year prospectively. The outcome assessment using Rasmussens score concluded good results. The average duration for union was ­6 months. ROM achieved in these patients were to be at least 124 degrees. The infection rate in this study was accounted as 13.3%. Open reduction and internal fixation of tibial plateau fractures, by dual plating has good functional and radiological outcome. This is an effective method of treatment even with moderate soft tissue injury if meticulous surgical technique, appropriate soft tissue handling and adequate healing period given. All these have shown to decrease the postoperative complications such as infection.&lt;/p&gt;