A comparative study of posterior approach versus surgical technique for posterior tibial plateau fractures

Abstract

Background: Tibial plateau fractures are intra-articular fractures caused by high-velocity trauma. They are usually associated with neurovascular injury, compartment syndrome, compounding of fractures, and crushing of soft tissues. Aim: The aim of our study is to investigate the benefits of using posterior approach and the surgical technique is beneficial for the union of fractures and prevention of postoperative complications in posterior fractures of the tibial plateau. Methods: This is a comparative prospective study was carried on 50 adult patients. All skeletally mature patients with closed tibial plateau fractures involving the posterior condyles confirmed on CT scan were included in the study. Open fractures, polytrauma, old or maluniting fractures, pathological fractures, and floating knee injuries or those associated with patella fractures were excluded from the study. Preoperative planning consisted of antero posterior and lateral views in all cases and amount of displacement, depression and angulation were recorded. Computed tomography (CT) scan was kept as an option in cases where fracture pattern or amount of depression was unclear. Results: There were 22 male and 3 female in group A and in group B 21 Male and 4 female patients were mostly affected by traffic accidents. Most common mode of injury was road traffic accidents; the second most common mode of injury was fall from height. Complications were not found to be significant in between the two groups. Perioperative parameters showed significant differences in both the groups; time for undertaking surgery post trauma was significantly different. Conclusion: The fixation does not expedite the fracture healing, but rehabilitation and patient-related scores are significantly better in our study. Surgical treatment with adequate physiotherapy can give good results in tibial plateau fractures.