Outcome Analysis of Dual Plating in Management of Unstable Bicondylar Tibial Plateau Fracture - A Prospective Study
INTRODUCTION: Bicondylar tibial plateau fractures account for 10-30% of tibial plateau fractures. Despite recent advancements in the management of unstable bicondylar tibial plateau fractures, the outcomes are often poor. The present study aimed to evaluate the functional outcomes and complications...
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| Format: | Article |
| Language: | English |
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Malaysian Orthopaedic Association
2021-11-01
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| Series: | Malaysian Orthopaedic Journal |
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| Online Access: | http://morthoj.org/2021/v15n3/bicondylar-tibial-plateau.pdf |
| _version_ | 1819349624314396672 |
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| author | Raj M Gill SPS Rajput A Singh KS Verma KS |
| author_facet | Raj M Gill SPS Rajput A Singh KS Verma KS |
| author_sort | Raj M |
| collection | DOAJ |
| description | INTRODUCTION: Bicondylar tibial plateau fractures account for 10-30% of tibial plateau fractures. Despite recent advancements in the management of unstable bicondylar tibial plateau fractures, the outcomes are often poor. The present study aimed to evaluate the functional outcomes and complications of internal fixation of bicondylar tibial plateau fractures with the dual plating using two incisions.
MATERIALS AND METHODS: The present study included 30 patients (26 males; 4 females, mean age 35.6 years; range, 19 to 65 years) with bicondylar tibial plateau fractures who were treated with dual plating between January 2017 to August 2019. Out of 30 patients, 5 patients had Schatzker type (V) and 25 patients had Schatzker type (VI) bicondylar tibial plateau fracture. All patients were treated with dual plating using two incisions. In all patient’s similar standard physical rehabilitation therapy was followed. All complications including intra and post-operative were assessed and recorded. The patients were followed-up for over 24 months. Functional outcomes were assessed with Rasmussen’s functional grading system, Oxford knee score, and range of motion of knee joint. Radiological outcomes were evaluated using Rasmussen’s radiological scoring system.
RESULT: All fractures united with a mean time of 18 weeks. The average knee range of motion was 1.5° - 130° (range: 0° - 10° for extension lag, range: 100° -135° for flexion). Mean Rasmussen's functional grading score at the final follow-up was 26.75. All patients showed excellent or good radiographic results according to Rasmussen’s radiological scoring with a mean score of 8.5 (range 6-10). The post-operative radiographs showed mean MPTA was 84.3° and the mean PPTA was 6.2°. In the present study, complications were encountered in five patients. However, there were no cases of secondary loss of reduction, failure of the implant, malunion, or non-union.
CONCLUSION: The surgical treatment of bicondylar tibial plateau fractures with dual locking represents a significant treatment option and provides rigid fixation in these fractures with good functional and radiological outcomes. |
| first_indexed | 2024-12-24T19:03:29Z |
| format | Article |
| id | doaj.art-aa205b70c5fe4693a4d8fa70435297eb |
| institution | Directory Open Access Journal |
| issn | 1985-2533 2232-111X |
| language | English |
| last_indexed | 2024-12-24T19:03:29Z |
| publishDate | 2021-11-01 |
| publisher | Malaysian Orthopaedic Association |
| record_format | Article |
| series | Malaysian Orthopaedic Journal |
| spelling | doaj.art-aa205b70c5fe4693a4d8fa70435297eb2022-12-21T16:43:09ZengMalaysian Orthopaedic AssociationMalaysian Orthopaedic Journal1985-25332232-111X2021-11-01153293510.5704/MOJ.2111.005Outcome Analysis of Dual Plating in Management of Unstable Bicondylar Tibial Plateau Fracture - A Prospective StudyRaj M0Gill SPS1Rajput A2Singh KS3Verma KS4MS OrthMS OrthDNB OrthMS OrthMS OrthINTRODUCTION: Bicondylar tibial plateau fractures account for 10-30% of tibial plateau fractures. Despite recent advancements in the management of unstable bicondylar tibial plateau fractures, the outcomes are often poor. The present study aimed to evaluate the functional outcomes and complications of internal fixation of bicondylar tibial plateau fractures with the dual plating using two incisions. MATERIALS AND METHODS: The present study included 30 patients (26 males; 4 females, mean age 35.6 years; range, 19 to 65 years) with bicondylar tibial plateau fractures who were treated with dual plating between January 2017 to August 2019. Out of 30 patients, 5 patients had Schatzker type (V) and 25 patients had Schatzker type (VI) bicondylar tibial plateau fracture. All patients were treated with dual plating using two incisions. In all patient’s similar standard physical rehabilitation therapy was followed. All complications including intra and post-operative were assessed and recorded. The patients were followed-up for over 24 months. Functional outcomes were assessed with Rasmussen’s functional grading system, Oxford knee score, and range of motion of knee joint. Radiological outcomes were evaluated using Rasmussen’s radiological scoring system. RESULT: All fractures united with a mean time of 18 weeks. The average knee range of motion was 1.5° - 130° (range: 0° - 10° for extension lag, range: 100° -135° for flexion). Mean Rasmussen's functional grading score at the final follow-up was 26.75. All patients showed excellent or good radiographic results according to Rasmussen’s radiological scoring with a mean score of 8.5 (range 6-10). The post-operative radiographs showed mean MPTA was 84.3° and the mean PPTA was 6.2°. In the present study, complications were encountered in five patients. However, there were no cases of secondary loss of reduction, failure of the implant, malunion, or non-union. CONCLUSION: The surgical treatment of bicondylar tibial plateau fractures with dual locking represents a significant treatment option and provides rigid fixation in these fractures with good functional and radiological outcomes.http://morthoj.org/2021/v15n3/bicondylar-tibial-plateau.pdfunstable bicondylar tibial plateau fractureschatzker type v and virasmussen’s criteriaoxford knee scoreradiological outcome |
| spellingShingle | Raj M Gill SPS Rajput A Singh KS Verma KS Outcome Analysis of Dual Plating in Management of Unstable Bicondylar Tibial Plateau Fracture - A Prospective Study Malaysian Orthopaedic Journal unstable bicondylar tibial plateau fracture schatzker type v and vi rasmussen’s criteria oxford knee score radiological outcome |
| title | Outcome Analysis of Dual Plating in Management of Unstable Bicondylar Tibial Plateau Fracture - A Prospective Study |
| title_full | Outcome Analysis of Dual Plating in Management of Unstable Bicondylar Tibial Plateau Fracture - A Prospective Study |
| title_fullStr | Outcome Analysis of Dual Plating in Management of Unstable Bicondylar Tibial Plateau Fracture - A Prospective Study |
| title_full_unstemmed | Outcome Analysis of Dual Plating in Management of Unstable Bicondylar Tibial Plateau Fracture - A Prospective Study |
| title_short | Outcome Analysis of Dual Plating in Management of Unstable Bicondylar Tibial Plateau Fracture - A Prospective Study |
| title_sort | outcome analysis of dual plating in management of unstable bicondylar tibial plateau fracture a prospective study |
| topic | unstable bicondylar tibial plateau fracture schatzker type v and vi rasmussen’s criteria oxford knee score radiological outcome |
| url | http://morthoj.org/2021/v15n3/bicondylar-tibial-plateau.pdf |
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