Abstract: Introduction: Tibial plateau is one of the most critical load bearing areas in the human body; Fractures of the plateau affects knee alignment, stability, and motion. These fractures constitute about 8% of all fractures in elderly and 1% overall. Plateau fractures cover a broad spectrum of injuries with differing degrees of articular depression and displacement. Published studies have shown that the majority of injuries affect the lateral plateau (55%–70%). Isolated injuries to the medial plateau occur in 10% to 23% of cases, while involvement of both plateaus, the so-called bicondylar lesions, is found in 10% to 30% of reported series.
Aim: To analyse functional and radiological outcome following internal fixation of tibial plateau fractures based on modified Rasmussen’s Clinical and Radiological criteria.
Materials and Methods: The study was undertaken at yenepoya medical college and hospital, mangalore. Ethics committee clearance was taken for the study and Patients who were diagnosed to have tibial plateu fractures and underwent internal fixation for the same in the year 2019, x rays/CT scans were analysed and tibial plateu fractures classified according to Shatzker‘s classification, retrospectively functional and radiological analysis was done according to modified Rasmussen’s Clinical and Radiological criteria at 3 to 6 months of follow up, all the patients were followed up upto 6 months.
Results: 21 patients were studied with mean age of 40.95, majority being males -17 and females being 3, highly significant association of this study is with male patients. Majority of the age group were of 2nd to 4th decade. Out of 21 subjects studied 17 of them had sustained road traffic accident and 4 of them had history of fall from height. Majority of them had left sided involvement-13, and 8 had right side tibial plateau fractures. Schatzker’ s type 2 was the type of fracture in majority and rest distribution of type of fracture as shown below. 6 cases were managed with cannulated screws +buttress plating, 1 case with percutaneous cc screw fixation, 8 were managed with Buttress plate, 3 by Buttress plate along with Bone graft and 3 cases with locking plate. All fractures united with in expected time not a single nonunion was noted in our study series, however 2 patients had knee stiffness and 2 patients experienced occasional pain, no cases had infection or wound problems. Mean Rasmussen score at final follow up was 23.05 (range 18 to 30) and the mean radiological score at the end of follow up was 7.5 (range 5 to 10).
Conclusion: To manage different types of tibial plateau fractures depends on good clinical judgement. The surgeon should have sound knowledge about personality of the injury and clear understanding of the knee examination and, imaging studies and should be Familier with the variety of techniques available at present for treating tibial plateau fractures.
