Abstract: Objectives: With the advancement in surgical, approaches, technique and newer fixation devices the treatment outcome of bicondylar proximal tibial fractures have improved. Therefore it is paramount to identify the appropriate treatment techniques for better functional outcomes in terms of better stability and early weight bearing without pain. Hence this study was carried out to study the functional outcomes of Intra-articular bicondylar tibial fractures, treated with operative management using contoured locking plate over both the condyles.
Material and Methods: This study was carried out as a prospective study. Fifty (50 fractures) patients with acute, displaced Intra-Articular bicondylar tibial aged above 18 years, were enrolled in the study. Open fractures and fractures older than two weeks were excluded. The functional outcome was assessed every 4 weeks. Assessment included OA change, limitation of ROM, or malalignment.
Results: Of the 50 patients, all were males. 35 patients had left sided fractures, while 15 had right sided fractures. Post operatively all 50 patients had swelling, 20 patients had persisting pain, 5 had superficial infections and 2 had deep infection. Superficial infections healed with antibiotics and dressings, while the patient with deep infection had persistent pain and difficulty in walking with discharge from surgical wound site. Both of them underwent implant removal and debridement after a year. Of the 50, 32 had OA changes, 14 had fair limited ROM and 4 had malalignment. Hence we conclude from the above findings that dual plate fixation helps in improving the functional outcome of the patients in view of their physical and radiological findings. Soft tissue problems should be kept in mind, and usage of locking plate can reduce the discomfort of hardware impingement effectively.
Conclusion: A relatively better functional outcome was observed in displaced and comminuted fractures in dual plating, provided that the intra-articular congruity was restored. The technique of dual plate fixation is good with regards to fracture union and functional outcome.
