Functional outcome of unilateral plating with lag screws in bicondylar tibial fractures

Abstract

Objective: Management of Bicondylar (tibial plateau) fractures is a challenge. In literature dual plating is considered to be the treatment of choice for these fractures. In this study we studied the functional outcome of open reduction internal fixation with plating on one side, enhanced by cannulated cancellous screws on the other side. Method: From October 2019 to October 2021, we studied 27 patients with bicondylar tibial plateau fractures (schatzker type V and Type VI) treated using plate on one side and cannulated cancellous screws (inserted percutaneously) on the other side. Result: The mean age was 40.03 ± 11.54 years. Most common mode of injury was road traffic accidents. We used schatzker classification to classify the fractures. Majority of the fractures (59.26 %) were schatzker type VI fractures. Post operative radiographs were taken at at 6 weeks, 3 months, 6 months and 12 months. The average time for union of fractures was 4.5 ± 2.28 months. 2 patients (8.70 %) developed deep wound infections, 1 (4.34%) of these had delayed union. 1 (4.34%) patient had lateral subluxation of knee post operatively with previous primary osteoarthritis. The rate of infection was lower than traditional dual plating. There were no cases of non-union or post operative loss of reduction. Conclusion: Per our limited experience we believe that open reduction internal fixation with plating on one side with cannulated cancellous screws on the other, is a better alternative in the management of schatzker Type V and VI tibial plateau fractures.