Outcome Of Tibial Plateau Fractures Research Articles

Dual plate osteosynthesis in bicondylar tibial plateau fractures-case series

<p>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.</p>

Surgical Management of Tibial Plateau Fractures with Locking Compression Plate


 INTRODUCTION
 Tibial plateau fracture is a common fracture that accounts for 1-2% of all fracture. Various treatment options including proximal tibial plating with locking compression plates are available for the treatment of tibial plateau fracture. This study was done to determine the clinical profile and functional outcome of tibial plateau fracture following locking compression plating.
 
 MATERIAL AND METHODS
 This prospective and observational study was carried out in Orthopedics Department of Universal College of Medical Sciences-Teaching Hospital (UCMS-TH) from December 2018 to July 2020. After Ethical clearance (UCMS/IRC/224/18) from Institutional Review Board (IRB) of UCMS-TH and informed written consent, all patients with tibial plateau fracture (Schatzker II-VI) who fulfilled the inclusion criteria were enrolled in the study and treated with locking compression plate. Post-operatively patients were regularly followed at 6 weeks, 3 months and 6 months for clinical, radiological and functional assessment. Descriptive statistics like frequency, percentage, mean and standard deviation were used to analyze the data.
 
 RESULTS
 In our study of 30 cases, the mean age was 37.77 ±15.65 years. Most of the cases were Schatzker type VI (13 patients) and type II (9 patients). The average duration for fractures union was 23.4 ±2.1 weeks. Superficial wound infection was the common complication seen in five cases. At six months, the mean knee society score (KSS) was 78 ±7.22 and majority of patients (19 patients) had good results.
 
 CONCLUSION
 Locking compression plate has an excellent functional and radiological outcome. It is an effective implant that can be adopted for the treatment of tibial plateau fractures in adults.

STUDY ON FUNCTIONAL OUTCOME OF TIBIAL PLATEAU FRACTURES TREATED WITH LOCKING COMPRESSION PLATE

Proximal tibial fractures, one of the commonest intra articular fractures. Incidence of these fractures is increasing due to road trafc accidents. At the same time surgical treatment options for the same are also being modied continuously. Any fracture around the weight bearing joint like knee joint is of paramount importance as it would result in signicant morbidity. Hence the treatment of proximal tibial fractures has become a challenge for the orthopaedic surgeons. Methods: During the study period 31 patients were treated with locking compression plate on lateral side through anterolateral approach for varying types of tibial plateau fractures. Out of 31, 28 patients were available at nal follow up. The functional and radiological outcome assessed with Rasmussen scoring system. At the end of study stability of the knee joint assessed with standard stability tests. Results: Most of the patients were sustained injury following major road trafc accidents and most of them were males. At nal follow up the functional outcome was excellent in 65 % of patients and good to fair in 35% of patients. No patient had poor functional outcome, though 10% of patients had poor radiological outcome. At the end of study 3 patients had posterior laxity, 2 patients had lateral meniscal injury and 4 patients had varus laxity. Conclusion: The functional outcome of tibial plateau fractures treated with single lateral locking compression plate was satisfactory in all our patients. All patients had acceptable clinical outcome though few patients had poor radiological outcome. We found 32% of patients with instability at the end of our study

Functional outcome of tibial plateau fractures treated with locking compression plates

Functional outcome of tibial plateau fractures treated with locking compression plates

Bone metabolism is a key factor for clinical outcome of tibial plateau fractures

PurposeGiven that tibial plateau fractures (TPF) are rare, they may pose a challenge to the treating surgeon due to their variety of complex fracture patterns. Numerous studies have identified potential fracture-specific, surgery-related, and patient-related risk factors for impaired patient outcomes. However, reports on the influence of bone metabolism on functional outcomes are missing.MethodsIn a retrospective multicenter cohort study, 122 TPF of 121 patients were analyzed with respect to radiological and clinical outcomes (Rasmussen) with a mean follow-up of 35.7 ± 24.9 months. The risk factor assessment included bone metabolism-affecting comorbidities and medication.ResultsThe findings showed that 95.9% of the patients reported a good-to-excellent clinical outcome, and 97.4% reported a good-to-excellent radiological outcome. Logistic regression revealed that potentially impaired bone metabolism (IBM) was an independent risk factor for the clinical (p = 0.016) but not the radiological outcome (Table 4). Patients with 41-type B fractures and a potential IBM had a seven times higher risk to present a fair-to-poor clinical outcome [OR 7.45, 95 CI (4.30, 12.92)]. The most common objective impairment was a limited range of motion in 16.4% of the patients, especially in 41-type C fractures (p = 0.06). The individual failure analysis additionally identified surgery-related options for improvement.ConclusionThis study demonstrated that potential IBM was an independent risk factor for a poor-to-fair clinical outcome.

Functional outcome of tibial plateau fracture managed conservatively

<p class="abstract"><strong>Background:</strong> Tibial plateau fractures involve the articular surface of the proximal tibia. They account for approximately 1% of adult fractures. A number of articles have been published regarding tibial plateau fracture management. Interestingly excellent results have been published concluding not all fractures of the tibial plateau require surgery and not all displaced intra-articular fractures need to be reduced surgically. In this method we used conservative method to restore normal joint anatomy, joint stability, and functional motion and avoid complications.</p><p class="abstract"><strong>Methods:</strong> This study design is prospective study including forty randomly selected cases of diagnosed tibial plateau fracture presented in Orthopaedic department of tertiary referral centre over 18 months period and treated with conservative method. The patients then were followed up and evaluation of outcome was analyzed as per modified Rasmussen clinical criteria and radiological criteria at six months.<strong></strong></p><p class="abstract"><strong>Results:</strong> In this study, tibial plateau fracture was seen more in patients of age group 31-40 (35%). Mean age being 41.25 years. There were 28 (70%) male and 12 (30%) female. Road traffic accident comprises the majority of cases (75%). Regarding radiological outcome, 41.5% had excellent result, 34.3% had good result, 8.5% had fair result and 15.7% had poor result. 84% had acceptable outcome. The Rasmussen’s functional outcome at final follow up was 46% patients had excellent result, 30% had good result, 12% had fair result and 12% had poor result. 88% had acceptable clinical outcome.</p><p class="abstract"><strong>Conclusions:</strong> Conservative management of tibial plateau is still a reliable, inexpensive and alternative treatment option with favourable functional outcome.</p>

Functional outcome of surgically treated Tibial plateau fractures

Background: Proximal tibia fractures are one of the commonest fractures encountered. The optimal treatment of such fractures are very important as the proximal tibia is one of the major weight bearing surface in the lower limb and it largely depends upon accurate articular reduction and the condition of the surrounding soft tissues. Thus this study aims at assessing the functional outcome of surgically treated tibial plateau fractures.Materials and Method: A prospective study of patients admitted with tibial plateau factures from the period of May 2014 to December 2015 who were surgically treated. The functional outcome was assessed using WOMAC score and Harkonen-Jarvinen criteria after a mean follow-up of one year. The statistical analysis was done using the paired t-test.Results: The present study included 15 patients diagnosed with Tibial Plateau fractures. The mean duration of surgery was 2 hours & 46 minutes. The mean blood loss was 220ml. The average time to union was 122 days. The mean range of motion of knee joint was 115°. Two patients developed knee instability & was diagnosed to have Anterior Cruciate ligament injury & Medial Meniscal injury respectively by diagnostic arthroscopy. The mean WOMAC score was 11.2. All the four parameters of HJ criteria were decreased postoperatively. Conclusion: The fractures of proximal tibia represent a wide spectrum of severity. The functional outcome of Tibial plateau fractures following surgery is good. However, surgery needs to be done once the soft tissue swelling decreases, articular reconstruction, and valgus/varus malalignment correction needs to be given preference, before internal fixation of such fractures.

Autologous Iliac Bone Graft Compared with Biphasic Hydroxyapatite and Calcium Sulfate Cement for the Treatment of Bone Defects in Tibial Plateau Fractures: A Prospective, Randomized, Open-Label, Multicenter Study.

Background:Bone-graft substitutes are commonly used for the augmentation of traumatic bone defects in tibial plateau fractures. However, their clinical performance compared with that of autologous bone-grafting, the gold standard in bone defect reconstruction, still remains under debate. This study investigates the differences in quality of life, pain, and radiographic outcomes in the treatment of tibial plateau fracture-associated bone defects with either autologous bone grafts or a bioresorbable hydroxyapatite and calcium sulfate cement (CERAMENT BONE VOID FILLER [CBVF]; BONESUPPORT).Methods:In this study, 135 patients with acute depression and split-depression fractures of the proximal part of the tibia (OTA/AO types 41-B2 and 41-B3) were enrolled in a prospective, controlled, randomized, multicenter trial including 20 hospitals in Germany. Patients were randomized to receive either autologous iliac bone graft or CBVF for reconstruction of the bone defect. The primary outcome measures were the Short Form (SF)-12 version 2 Physical Component Summary (PCS) score at week 26 (the study was designed to show noninferiority of the CBVF with regard to the PCS with a prespecified margin of −5 points) and the pain level at 26 weeks postoperatively measured by a visual analog scale (VAS). The secondary outcomes were the SF-12 version 2 Mental Component Summary (MCS) and SF-12 PCS scores at weeks 1, 6, and 12 and bone-healing on radiographs.Results:Age, sex, fixation methods, and fracture pattern were comparable in both groups. There were no significant differences (p > 0.05) in the SF-12 PCS or VAS scores at postoperative week 26. There was a significant reduction of blood loss (p = 0.007) and pain levels (p = 0.008) at postoperative day 1 in the CBVF group. The rates of fracture-healing, defect remodeling, and articular subsidence were not significantly different (p > 0.05) in both groups.Conclusions:Bioresorbable CBVF was noninferior to autologous bone graft with regard to both patient-reported and radiographic outcomes in tibial plateau fractures of OTA/AO types 41-B2 and 41-B3.Level of Evidence:Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Prospective study to measure the functional outcome of tibial plateau fractures

<p class="abstract"><strong>Background:</strong> Tibial plateau fractures are complex injuries of the knee. The tibial plateau is one of the most critical load-bearing areas in the human body. Early detection and appropriate treatment of these fractures are essential in minimizing 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 and their management.</p><p class="abstract"><strong>Methods:</strong> This is prospective study which comprises of 50 patients with displaced tibial plateau fracture and were treated between January 2018 to December 2018 with minimal invasive percutaneous plate osteosynthesis and cortico-cancellous screw fixation. Statistical analysis was done by Chi-square test and IBM SPSS software.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our study we included 50 cases, treated with surgical procedure, 30 cases gave excellent result, 16 cases came out with good result, fair in 3 cases and 1 case had poor result. High velocity injuries have poor outcome than low velocity injuries. A single case of malunion was noted in study. Four cases had knee joint stiffness.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that functional outcome is good in operatively treated patients. Early physiotherapy plays key role in preventing knee stiffness, use of bone grafts and good fixation important for successful outcome.</p>

Outcome of tibial plateau fractures treated by hybrid and Ilizarov external fixation

<p class="abstract"><strong>Background:</strong> Tibial plateau fractures pose a challenge to the treating surgeon especially in cases with compromised soft tissue envelope. External fixation achieves good results with minimal complications. The objective of our study was to evaluate the functional outcome of tibial plateau fractures treated by Ilizarov and hybrid external fixation.</p><p class="abstract"><strong>Methods:</strong> 46 patients with tibial plateau fractures were analysed. 6 were lost to follow-up. 20 patients were treated by Ilizarov method and 20 by hybrid external fixation.<strong></strong></p><p class="abstract"><strong>Results:</strong> Mean time for union was 24.5 weeks in Ilizarov fixator group and 28 weeks in hybrid fixator group. Mean Lysholm’s score was 86.1 in Ilizarov cases and 83.4 in hybrid fixator cases. The mean knee society score in Ilizarov fixation cases was 78.5 and 77.3 in hybrid fixator cases. At one year by Lysholm score 6 patients had fair, 10 had good and 4 had excellent result in Ilizarov group and 1 had poor, 8 had fair, 8 had good and 3 had excellent results in hybrid group. 15 patients in Ilizarov method had good and excellent knee society scores and 12 patients had good and excellent results and 1 patient had poor score in Hybrid fixator group.</p><p class="abstract"><strong>Conclusions:</strong> External fixation in complicated tibial plateau fractures gives acceptable outcomes. Ilizarov external fixator has an advantage of earlier mobilization and earlier union but requires longer operation time and a bulky apparatus. Hybrid fixator on the other hand has lesser operating time and simpler construct but has less stability and longer union time.</p>

A study on outcome of tibial plateau fractures (TPF) at a tertiary care hospital

The head of the tibia is sometimes obliquely broken; and if it be fractured into the knee joint the treatment which it requires is similar to that which is necessary in the oblique fracture of the condyle of the Os femoris; i.e., Firstly, the straight position of the limb, because the femur preserves the proper adaptation of the fractured tibia by forming a splint to its upper portion, and keeping the articular surfaces in apposition. Secondly, a roller, to press one part of the broken surface against the other. Thirdly, a splint of pasteboard, to assist in the preservation of that pressure and fourthly, early passive motion to prevent ankylosis. All surgeries were performed under either spiral or lumbar plexus block with Sciatic nerve block. Tourniquet was not used in any of the patients. Patient was positioned supine on the fracture table. Traction was given along the axis of the limb, fracture reduced by closed manipulation with the help of C arm. Condyles were fixed with 6 mm cannulated lag screws and olive wires. Most of the patients were followed up for a period of 23 months. The longest follow up was 24 months and the shortest was 3 months. Average duration of follow up was 16.3 months. The maximum flexion achieved was 150 deg [2 patients] and minimum was 90 deg [4 patients] and 7 patients had a flexion of 135 deg. The average flexion achieved was 118.25 deg.

Functional outcomes after surgical treatment of tibial plateau fractures

Tibial plateau fractures are significant because of its intra-articular nature. In this study, we aim to evaluate the functional outcomes of tibial plateau fractures after surgical treatment and to determine the rates of return to work and sports after recovery.This is a retrospective study conducted at a single tertiary-level institution. Forty-one patients with tibial plateau fractures were operatively treated during our study period. Patient information including injury mechanism, surgical treatment and associated injuries were documented. Pre-operative and post-operative radiographs were reviewed to confirm Schatzker type and adequacy of reduction. Follow up data for thirty-one patients was obtained nineteen to forty-two months post-surgery. All patients were administered functional outcome questionnaires using the Western Ontario and McMaster University Osteoarthritis index (WOMAC) and Short Form 36 (SF-36) general health survey. Data regarding return to work and sports was also collected. Data analysis was done to determine the relationship between fracture type, adequacy of reduction and functional outcome.The average WOMAC score for patients with Schatzker I to III was 6.3 out of a maximum score of 96, significantly lower than the Schatzker IV to VI group, whose average score was 18.4 (p = 0.0012). The SF-36 score for the Schatzker I to III group was also significantly higher than the VI to VI group (p = 0.0031). 71% of patients reported partial to full return to work, while 65% of patients did not return to sports after injury.In conclusion, the functional outcome of operatively treated tibial plateau fractures is satisfactory, with poorer functional outcome being associated with higher energy fractures. (Schatzker IV to VI) Majority of patients were able to return to their pre-injury employment but only a small minority were able to return to sports.

The Use of Intra-articular Steroid Injection to improve functional outcomes in Tibial Plateau Fractures

Tibial plateau fractures should be properly managed, otherwise, they may end up in serious complications. These complications include limitation of movements, osteoarthritis and may finally result in joint stiffness. From February 2017 to August 2017, a study was conducted including 30 patients with united tibial plateau fractures to evaluate the role of intra-articular corticosteroid injection in improving the clinical outcomes after open reduction and internal fixation. Ten patients had Schatzker type I tibial plateau fractures, 13 patients had Schatzker type II and seven patients had Schatzker type III fractures. Average follow-up was 13.5 months. The average total clinical Rasmussen score was 28.3. It was excellent in 19 cases, and 11 cases had good results.

Evaluation of role of fibula in functional outcome of tibial plateau fractures

Introduction: Tibial plateau fractures occur due to a combination of axial loading and varus/valgus applied forces leading to articular depression, malalignment and an increased risk of posttraumatic osteoarthritis (OA). Various treatment modalities have been used over the years, with mixed results. We present a study to report the functional results of tibial plateau fractures and to evaluate the association of proximal fibula fractures with respect to final outcome. Methods: Patients diagnosed with tibial plateau fractures from July 2012 to March 2016 were included in the study. Patients with open injuries or neurovascular compromise were excluded. Patients were divided into subgroups on the basis of presence or absence of proximal fibula fracture. 124 patients were managed by either conservative or operative means and followed for an average of 19 months and clinically monitored for functional outcome using Knee Injury and Osteoarthritis Score. Results: The study population consisted of 65 males and 59 females. Mean patient age was 46 years (range, 24-67 years). Mechanism of injury included road traffic accident (56), fall from height (14), and falls (54). Functional outcome as assessed by Knee Injury and Osteoarthritis Outcome Score was comparable to previous studies. Role of proximal fibula in supporting the lateral condyle was evident from better functional outcomes seen in patients with intact fibula and lateral condyle fracture. Conclusion: An intact fibula contributes to the mechanical stability of the lateral tibial plateau. Therefore, the knee joint will be affected by injury of the bone or soft tissue that may occur in fibula fractures. A consideration to presence of proximal fibula fractures should be given while classifying tibial plateau fractures.

Functional outcome of tibial plateau fractures, Schatzker type V and VI treated surgically with plate osteosynthesis

Functional outcome of tibial plateau fractures, Schatzker type V and VI treated surgically with plate osteosynthesis

Effectiveness of the management of bony articular collapse with bony defects in tibial plateau fractures with the use of genex: An absorbable calcium composite synthetic bone graft

Background: Synthetic grafts containing calcium sulfate and calcium phosphate are used to manage defects and support the articular surface in the management of periarticular fractures. GeneX is a synthetic graft that contains beta-tricalcium phosphate and calcium sulfate. Objectives: This study's aim was to assess the maintenance of elevated articular segments in tibial plateau fractures grafted with a synthetic calcium composite graft. Methods: Patients who received a single synthetic calcium composite graft intraoperatively at a single Level 1 Major Trauma Centre were identified. Case notes and radiographic images were reviewed to assess articular collapse, mode of fixation, maintenance of the articular surface, and reoperation rates. All intra-articular segments were elevated, graft applied, and combination of implant (circular frame/plate) were used for definitive fixation along with raft screws. There were forty tibial plateau with average preoperative collapse of 13.12 mm (2.2−50). Modes of definitive fixation: frame and raft screw technique 19, plate 18, and screws alone 3. Results: Two (5%) had postoperative collapse after anatomical reduction intraoperatively (one plate and one circular frame). Five demonstrated inadequate reduction intraoperatively, three circular frames, and 2 plates as definitive mode of stabilization. Four maintained inadequate reduction at final X-ray but one collapsed postoperatively. Of those with collapse, final average was 4.2 mm (3−5.3). Five patients required secondary surgery and none directly attributable to the synthetic graft. Conclusions: The use of the synthetic graft GeneX with subchondral raft screws along with circular frame or plate appears to be safe and effective in providing support to elevated intra-articular fractures and provides satisfactory outcomes in tibial plateau fractures.

Surgical outcome of tibial plateau fracture using minimally invasive technique with locking compression plate

Introduction: The following study was conducted to examine the short term clinical and radiological results particularly early complications and healing rate of tibial plateau fractures treated with LCP by minimally invasive technique. Methodology: The study was conducted in patients treated for tibial plateau fractures (type 1 to 4 Schatzker classification) at Adhichunchangiri Institute of Medical Science, BG Nagar from the month of May 2011 to May 2016. Fifty tibial plateau fracture patients were taken into the study, all were fixed with LCP using minimally invasive technique. Patients’ age ranged from 20 to 70 years with a mean of 45. Results: The sample consisted of twenty patients with 38 males and 12 were females. The patients’ ages ranged from 20-70 years with a mean age of 45 years. The causes of fractures were motorvehicle accident in 36 patients and fall in 14 patients. There were no sports or industrial accidents. 31 fractures involved the right side and 19 involved the left. The average length of hospitalisation was 12 days with a range of 7 to 20 days. The average number of days from injury to surgery was 5 days with a range of 2 to 10 days. The operative time ranged from 45 minutes to 100 minutes. Patients were followed up from 01 to 24 months. Functional outcome was rated as per NEER’S RATING SCORE, we got excellent results in 24 cases, good in 15, fair in 08 and poor in 03 patients. Conclusion: Treatment of tibial plateau fractures using LCP provides good results. Since we have used minimally invasive technique soft tissue damage is minimal thus promoting good healing of fracture and less infection rates. Our early results were encouraging but long term studies are needed to prove definitively acceptable outcomes so that the technique can become part of the in the armamentarium of the orthopaedic trauma surgeon.

Functional outcome of intra-articular tibial plateau fractures: the impact of posterior column fractures.

INTRODUCTION: Although regularly ignored, there is growing evidence that posterior tibial plateau fractures affect the functional outcome. The goal of this study was to assess the incidence of posterior column fractures and its impact on functional outcome and general health status. We aimed to identify all clinical variables that influence the outcome and improve insights in the treatment strategies. A retrospective cohort study including 218 intra-articular tibial plateau fractures was conducted. All fractures were reclassified and applied treatment was assessed according to the updated three-column concept. Relevant demographic and clinical variables were studied. The patient reported outcome was assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS). Median follow-up was 45.5 (IQR 24.9-66.2) months. Significant outcome differences between operatively and non-operatively treated patients were found for all KOOS subscales. The incidence of posterior column fractures was 61.9%. Posterior column fractures, sagittal malalignment and an increased complication rate were associated with poor outcome. Patients treated according to the updated three-column concept, showed significantly better outcome scores than those patients who were not. We could not demonstrate the advantage of posterior column fracture fixation, due to a limited patient size. Our data indicates that implementation of the updated three-column classification concept may improve the surgical outcome of tibial plateau fractures. Failure to recognize posterior column fractures may lead to inappropriate utilization of treatment techniques. The current concept allows us to further substantiate the importance of reduction and fixation of posterior column fractures with restoration of the sagittal alignment. 3.

To assess the functional outcome of tibial condyle fractures following open reduction and internal fixation with plate and screws -A prospective study

Purpose: To evaluate the functional outcome of tibial plateau fractures treated by open reduction and internal fixation with buttress plating and cancellous screws. Methods: A prospective study of 25 patients with tibial condyle fractures treated by open reduction and internal fixation at the Government Medical College Trichur during year 2008-2010 was be considered for the study. Results: Functional grading was done based on. Modified knee scoring system of Hohl & Luck (1956) – (modified by Dennis Bo Jensen, Claus Raud et al) No patient had lack of extension i.e., all of them were able to extend. But range of movement was limited in few patients. 68% had more than 1200. 16% had < 1200 and > 900 movement and 12% having range of motion between 75 and 90 degrees. Similarly instability was not observed widely. Only 4% had > 5o of instability. 4% was unable to walk more than 100 m and all others were able to walk without much pain. Considering all parameters, the total pain score was assessed and 88% had no pain and 8% had mild pain and 4% had moderate pain. All the patients were assessed functionally and assigned grade for their performance. 68% performed excellently and 16% showed good performance and performance is fair only in 12% and 4% performed poor. All the patients were assessed radiologically and assigned grade for their performance. 92% performed excellently and 4% showed good performance and only 4% performed fair. Conclusion: The overall analysis of this study showed that the functional results were much better with types I, II, III and IV fractures than the complex fractures. Complication rates were also more with type V and VI fractures. Bicondylar fractures can be effectively treated by reduction and fixation with lateral locking plate Bone grafting after elevation of the depressed fracture is always advisable as it gives a good anatomical as well as functional outcome Post-operative /wound breakdown &infection is a major complication, The chance of infection, delayed wound healing and wound breakdown in complex tibial fractures (types IV, V and VI) are high.

Prospective Case Study of Outcome of Tibial Plateau Fractures Treated with Locking Condylar Plate.

Introduction: Tibial plateau injury involves the articular surface of the proximal tibia with diverse group of fractures that represent a wide spectrum of severity that challenge even the most experienced surgeons, but with the invent of modern diagnostic technology and the advent of locking plates, results appear to be improving over time.Method: The study was conducted on thirty patients admitted in the department of orthopaedics with diagnoses of tibial plateau fractures treated with Locking Condylar Plate. The patients were followed up for a minimum period of six months and clinico-radiological progression of fracture union with the functional outcome was studied using 100 point rating system devised by Delamarter et al.Result: Twenty-two patients showed excellent results while eight patients had good to fair and none with poor result. The average time for radiological union was 17.5 weeks.Conclusion: The results of the study concluded that while locking condylar plate seems to show excellent results in low energy tibial plateau fractures, it can probably be used to successfully treat patients with high energy fracture patterns without the need for additional medial stabilization.