Functional outcome of tibial plateau fractures, Schatzker type V and VI treated surgically with plate osteosynthesis

Abstract

Introduction: Tibial plateau fractures are serious injuries resulting frequently in functional impairment. For the more severe form of injury which results in comminuted tibial plateau fractures (Schatzker type V and VI) the ideal mode of treatment is always debatable. Aim of Management in tibial plateau fractures are anatomic reduction of the articular surface, restoration of axial alignment, and stable fixation which can be achieved very well by open reduction and internal fixation (ORIF),using a plate and screws. Objective: To study the functional and radiological outcome of Tibial plateau fractures, Schatzker type 5 and 6 treated surgically with plate osteosynthesis. Methods: 30 patients in the age group 18-60 were selected. Prospectively followed up clinically and radiologically for minimum one year. Functional assessment was done with Knee Society Score and Radiological evaluation done by Rasmussens score. Results: Functional outcome as assessed by Knee Society Score had excellent to good results while the radiological outcome as assessed by Rasmussens criteria too had good results. The average duration for fracture union was 15.2 weeks. 18(60%) patients had at least 120degrees or above of flexion. The infection rate in this study was accounted as 16.6%. 6 patients out of the study group had varus or valgus deformity. Conclusion: Open reduction and internal fixation by plate osteosynthesis of closed Tibial plateau fractures, Schatzker type V and VI has good functional and radiological outcome and is an effective method of treatment even with moderate soft tissue injury when adequate healing period is given which minimised postoperative complications such as infection.

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