A comparative study of treatment of bicondylar tibial plateau fractures using locked plating versus hybrid fixator
Abstract
Tibial plateau fractures present a wide spectrum of injuries with a range of fractures patterns involving varying degree of joint surface depression and displacement. This study was conducted to compare the outcomes of locked plating and hybrid fixator in management of tibial plateau fracture. This study observed that in plating group mean interval between surgery and partial weight bearing was 8.45 weeks and in hybrid group it was 11.14 weeks which was with significant difference (p=0.0006). Likewise in plating group mean interval between surgery and full weight bearing was 14.11 weeks whereas 17.82 weeks in hybrid group (p=0.001). In plating group mean time for radiological union was 20.9 weeks whereas it was 24.81 weeks in hybrid group (p=0.023). In this study plating group 14.28% had malunion whereas in hybrid fixator group it was in 31.42% of cases (p=0.087). Nonunion were in 5.71% in plating and 8.57% in hybrid group which was not found significant (p=0.642). In plating group mean Rasmussens score was 23.25 at 24 weeks follow up whereas it was 21.08 weeks in hybrid group which was found with significant (p=0.043) difference. This present study concluded that although distribution of malunion, nonunion cases and duration of hospital stay was without significant difference in plating and hybrid fixator group but partial weight bearing, full weight bearing, radiological union was earlier in plating group than hybrid fixator group. Rasmussens score of knee was higher in plating than hybrid fixator group. So plating is better than hybrid fixator method in treatment of tibial plateau fracture.
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Introduction
With increasing industrialization and road traffic accident there has been a corresponding increase in the case of tibial plateau fractures constitute 1% of all fractures and 8% of fractures in the elderly. No age is exempted from fracture of condyles of tibia. 1
Tibial plateau fractures caused by a varus orvalgus force combined with axial loading.2 Tibial plateau fractures present a wide spectrum of injuries with a range of fractures patterns involving varying degree of joint surface depression and displacement.
Fractures of tibial plateau comprise a diverse group of fracture pattern that range in severity from minor injuries that have predictably excellent outcome after simple treatment to fractures at risk for limb threatening complications.
High energy tibial condyle fractures present multifaceted problems of difficulty of achieving accurate joint reconstruction
Conclusion
This present study concluded that although distribution of malunion, nonunion cases and duration of hospital stay was without significant difference in plating and hybrid fixator group but partial weight bearing, full weight bearing, radiological union was earlier in plating group that hybrid fixator group. Rasmussens score of knee was higher in plating than hybrid fixator group. So plating is better than hybrid fixator method in treatment of tibial fracture.