Abstract: Background: Knee joint is an important joint as it is involved in varied functions like load bearing, walking, running, sitting etc. Tibial plateau fractures are encountered in high velocity trauma, which are associated with high morbidity and mortality. Complications include fat embolism, compartment syndrome, ARDS, which necessitates early fixation. Among tibial plateau fractures, Schatzker type V and type VI are complex injuries and treated by internal fixation by plates and screws with or without augmentation by cannulated cancellous screws.
Aim: To analyze the post-operative surgical outcomes of Schatzker type V and type VI tibial plateau fractures treated by open reduction and internal fixation by plating with or without augmentation by cannulated cancellous screws.
Materials and Methods: Patients were admitted in Mallya Hospital, Bangalore in between October 2016 to November 2018. Total of 45 Patients with Schatzker type V and type VI tibial plateau fractures included in the study. Closed fractures and open type I and type II without severe soft tissue injury were included. The patients were recruited to the study after due consent. Patients were operated by open reduction and internal fixation by plating (Dual LCP, Single LCP, Single LCP + CC SCREWS) through anterolateral approach for lateral plate and posteromedial approach for medial plate. Further patients were followed up postoperatively, 6 weeks, 3 months and 6 months. Surgical outcomes were analyzed as subjective, clinical, radiological and functional outcomes based on Honkonen and Jarvinen Criteria.
Results: 45 cases were included in study, out of which 7 were lost to follow up. Minimum age of the patient was 22 years and maximum 67 years. There were 29 males and 16 female patients. 24 patients were Schatzker type V and 14 patients were Schatzker type VI. 18 patients were operated with single plating, 12 were by single plating + CC screw, 8 were operated with dual plating.
There was no statistical difference in the subjective (p value-0.345) functional. (P value-0.221),
Clinical (p value-0.153), radiological (p value-0.590) outcomes between type V and type VI fractures.
Conclusion: We concluded that Open reduction and internal fixation by plating (dual LCP, single LCP with or without cancellous cannulated screws) of closed and open (type I and type II) Schatzker type V and VI tibial plateau fractures is an effective method of treatment.
Prognosis of this complex fracture depends on
. The degree of articular reconstruction
. The integrity of the soft tissue envelope
. Post-operative physiotherapy
We found no statistical difference in assessing the Schatzker type V and VI fracture patterns. Comparable Results were achieved in radiological, clinical, subjective and functional outcomes based on Honkonen and Jarvinen criteria.
