Functional outcome assessment of columnar fixation in proximal tibia fractures: A prospective study

Abstract

Introduction: Tibial plateau fractures are common intra-articular fractures, representing 1.2% of all fractures. Most complex tibial plateau fractures are a result of the high-energy injury. Comminution makes interpretation of fracture patterns difficult. Complete understanding of these fractures is the basis for successful treatment.Material and Methods: This is a prospective study; 30 patients with tibial plateau fractures operated at Bangalore medical college were included in this study. The follow-up period was 24 months. The fractures were evaluated by computed tomography using three-column concepts and managed as per column-specific fixation. Follow-up analysis was made using KSS & Modified Rasmussen Radio-logical Criteria.Results: In our study of posterior column fixation group radio-logical outcome results were excellent in 4 (66.68%) cases and good in 2 (33.32%) cases and in posterior column non fixation group excellent were 3 (16.68%), good were in 12 (66.66%), fair were in 3 (16.68%). Functional out come in posterior column fixation group were excellent in 5 (93.33%) cases, fair in 1 (3.33%) case and in non-fixation group 15 (83.32%) cases showed excellent and 3 (16.68%) cases showed good scores. Based on the final results achieved, posterior column fixation group showed excellent radiological results compared with posterior column non fixation group in which results are good, but functional outcome was same in both groups.Conclusion: Based on our study we conclude that column specific fixation is a better option compared to conventional method of fixation as it provides better visualization, control over fragment, stable reduction and fixation of fragment. Even though radio-logical outcome is better in posterior column fixation group, functional outcome remains to be same in both the groups. It requires long term follow up and large number of patient study to assess the effectiveness of posterior column fixation. However column specific fixation requires surgeon’s expertise and experience.

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