Abstract: Background: Fractures of the tibial plateau involve the articular surface of the proximal tibia. The principles and techniques of treating tibial plateau fractures have evolved dramatically over the past 50 years. Tibial plateau fractures have been studied and reported extensively and exhaustively but still controversy exists over its management. Our aim is to outline the various principles of management of tibial plateau fracture and to evaluate the results of surgical and conservative methods.
Materials and Methods: Fifty adult patients with closed intra-articular tibial plateau fractures were treated by various surgical and conservative methods during period from Oct 2020 to Oct 2021. The patients were followed for 3rd, 6th, 12th week and then every 6 weeks till 6 months. Results were assessed with Modified Rasmussen Clinical and Radiological Scores.
Result: According to Modified Rasmussen clinical score, we had 19(38%) excellent results, 19(38%) good results, 09 (18%) fair results and 03(06%) poor results. In surgically treated patients we found 16, 16, 3, 1 patients in excellent, good, fair and poor category respectively and in conservatively treated patients 3, 3, 6, 2 patients in excellent, good, fair and poor category respectively. Radiologically, we had 16(32%) excellent results, 22(44%) good results, 12 (24%) fair results and 00(00%) poor results. In surgically treated patients we found 14, 17, 5 patients in excellent, good and fair category respectively and in conservatively treated patients 2, 5, 7 patients in excellent, good and fair category respectively.
Conclusion: Conservative treatment used for un-displaced or minimally displaced fractures showed good results in general while operated patients uniformly showed good results with stable fixation irrespective of implants used. External fixator as a definitive modality predisposed to stiffness due to prolong immobilization. Surgically treated patients have better radiological as well as clinical outcomes compared to conservatively treated patients because of good anatomical reduction and early mobilization of knee joint.
