Functional outcome of Column-specific Fixation of Complex Tibial Plateau Fractures

Abstract

Background: Complex tibial plateau fractures are usually high energy injuries presenting with significant articular and soft tissue damage in a major weight bearing joint. The knee is a complex dynamic joint that is subjected to many forces during normal activities, so intact articular surface of tibial plateau is one of important factors to keep the geometry and alignment of the knee joint to act in harmony to perform its crucial function as a flexible weight bearing joint. Material and Methods: This prospective study was conducted in the Department of Orthopaedics, a Tertiary Care Teaching Hospital, 27 patients with displaced tibial plateau fractures with posterior column involvement were selected for the study. All age group Patients with complex proximal tibia plateau fractures & closed injuries were included in this study. Involving two or more columns were classified based on the new three column classification system, patients with normal neurovascular function before primary surgery, patients with closed fractures, patients with good soft tissue condition, and patients without serious medical diseases and obvious surgical contraindications. Result: In our study, the most of the patients were belongs to 21-30 years old 13 (48.1%). In table 2, predominant were males 92.5% and females were of 7.4%. In our study majority of patients were Three-column fractures, followed by Two-column fracture and Single-column fractures. After operative procedure, 3 (11.1%) patients got discharged on post op day-7, 14 (51.8%) patients on post op day-8, 7 (25.9%) on post op day-9 and 3 (11.1%) on post op day-10. Conclusion: Using this new column specific strategy to the treatment of these two or more column tibial plateau fracture injuries, which involves evaluation of three columns, we believe we achieved satisfactory results.