Functional outcome of internal fixation of tibial plateau fractures: an observational study

Abstract

Background: Tibial plateau fractures are intra-articular fractures usually caused by high energy trauma either a valgus or varus force in combination with axial loading which affect the stability and function of weight bearing knee joint. Understanding the outcomes of surgical treatment for these fractures is crucial for both orthopaedic research and patient care. This study set out to examine the functional results of surgically managing tibial plateau fractures. Methods: This prospective observational study took place in the Department of Orthopedic Surgery at Bangabandhu Sheikh Mujib Medical University in Dhaka, Bangladesh, from January 2020 to December 2022. The study included 37 patients with tibial plateau fractures who underwent internal fixation. Data was analyzed using tools from Microsoft Office. Results: Among the study participants, 56.8% had an immobilization period of 1 week or less, and 32.4% were immobilized for 2-3 weeks. Complications included knee stiffness in 10.8% and malunion in 8.1% of cases. According to the Rasmussen grading system, 51.4% achieved an excellent outcome, 35.1% were categorized as good, while 8.1% and 5.4% fell into the fair and poor categories. Functional outcome was assessed by Oxford knee score is excellent 20 (54.5%), good 11 (29.7%), fair 4 (10.8%) and poor 2 (5.4%) respectively. Conclusions: Surgical treatment of tibial plateau fractures typically yields positive results in most cases. The use of internal fixation, particularly with locking compression methods, is considered an effective approach for treating these fractures. This technique is associated with a lower risk of complications and promotes efficient healing, contributing to favourable outcomes.

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