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Volume 14 Issue 1 (January) 2025

Original Articles

Evaluation of radiological and functional outcomes of Schatzker type V and VI tibial plateau fractures treated by dual-plate osteosynthesis via two incisions
Dr. Sankalp Agarwal

Introduction: The management of Schatzker type V and VI tibial plateau fractures remains a challenging task despite the advent of various new devices and techniques. The goals of treatment are to obtain a stable, painless, and mobile joint; and also to prevent secondary degenerative arthritis. Anatomic reduction of the articular surface, restoration of axial alignment, and stable internal fixation are essential prerequisites to attain this objective, and it can be well realized by open reduction and internal fixation by dual plates through two incisions. Objective: To study the radiological and functional outcomes of Schatzker type V and VI tibial plateau fractures treated by open reduction and internal fixation by dual plates via two incisions. Materials and methods: 30 patients within the age group 21-59 years with Schatzker type V and VI tibial plateau fractures were included in the study. It was a prospective study conducted at B.L. Kapur Superspeciality Hospital, New Delhi, between August 2019 and January 2021. All patients underwent open reduction and internal fixation by dual plates using two incisions . The follow-up period varied from minimum 24 weeks to maximum 48 weeks . The results were analyased using Rasmussen’s anatomical and functional grading systems. Results: The percentage of excellent , good and fair outcomes were 56.7,36.7 and 6.7 respectively as per Rasmussen’s radiological criteria; and 36.7 , 53.3 and 10.0 respectively as per Rasmussen’s functional criteria . There was no poor result in this study. The average duration for radiological fracture union was 18.4 weeks . 90% patients had at least 90o knee flexion . Conclusion: Dual-plate osteosynthesis via two incisions is an effective and safe method of treatment of Schatzker type V and VI tibial plateau fractures, as it provides adequate exposure for restoration of congruity of tibial articular surface and stable internal fixation of fracture fragments under direct vision with minimum soft-tissue striping and complications.

 
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