Abstract: Objective: The main objective of the study is to emphasizes the importance of the postero-medial fragment in the management of the tibial plateau fractures and study the functional outcome in Proximal tibia fracture treated with buttress plating. So accurate reduction and buttressing the fragment is essential for excellent functional outcome.
Materials and Methods: It was a single center Retrospective and prospective study. 60 patients, with mean age 50.53 + 13.47, presenting with traumatic fractures of proximal tibial having posteromedial fragment treated with buttress plating via posteromedial approach were included in the study and were followed up for the period of 1-year post-surgery. Anatomical and functional evaluation was done using the modified Rasmussen’s clinical and radiological criteria.
Results: Mean Rasmussen’s Clinical Outcome score was 26.63 ± 2.63 with 53.33% (32 patients) showed excellent clinical outcome and 30% (18 patients) showed good outcome. Mean Rasmussen’s Radiological Outcome score was 8.3 ± 0.95 with 60% (36 patients) showed excellent radiological outcome and 33.33% (20 patients) showed good outcome. The correlation between Rasmussen’s Clinical and Radiological Score was found to be strongly positive (R=0.76) which was a statistically significant finding (p<0.05). The correlation between Rasmussen’s Clinical and Radiological Score with Age of patients was found to be negative (p=0.03). There was a significant difference in Mean Clinical and Radiological Scores of Patients between different classification groups, Highest score were seen in patients with One Column involvement followed by Two column (p <0.05).
Conclusion: The study emphasizes the importance of the postero-medial fragment in the management of the tibial plateau fractures. Accurate reduction and buttressing the fragment is essential for excellent functional outcome. The goal of treatment of these fractures aims at stability and perfect articular reduction, both of them are not possible without reduction and fixation of the posteromedial fragment.
