scholarly journals A prospective study of surgical management of bicondylar schatzker type V & VI tibial plateau fracture by dual plating and dual incision

2019 ◽  
Vol 5 (3) ◽  
pp. 46-54
Author(s):  
Dr. Manjunath J ◽  
Dr. Ashish BC ◽  
Dr. Shashidhara H ◽  
Dr. Venkatramana Rao
Author(s):  
Tutika Dinesh Kumar ◽  
Deepak Chamalla ◽  
Santhosh Babu Miryabbelli ◽  
M. Sai Ashok

<p class="abstract"><strong>Background:</strong> Tibial condyles with their articular surface forms major part of the knee joint, plays an important role in weight transmission and mobility. The proximal tibia fractures account for 1% of all the fractures. If these high velocity intra/peri articular fractures are not treated properly there will be high degree incidences of malunion, non-union, peri-op infections vs collapse of the medial condyle, ligamentous instability, malalignment of the axis, articular incongruity leading to post traumatic arthritis. Aim was to assess the anatomical reduction of articular surface of upper end of tibia and knee joint perfectly by operative treatment with internal fixation.  </p><p class="abstract"><strong>Methods:</strong> The study was done for a period of 1 years on 30 patients with bicondylar tibial plateau fractures diagnosed with Schatzker type V and VI. Age ranged from 20-60 years with majority being in 30-39 years range with a largely male preponderance. Patients were followed up to 12 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> Our study reported Honkonen Jarvinen clinical outcome to be 86% excellent, 11.7% good and 1.7% fair. The functional outcome was 81% excellent, 13% good, 5% fair and 1% poor. The Radiological outcome showed 79.2% excellent, 12% good, 0.70% fair results. Our study used Honkonen Jarvinen criteria for radiological, functional, clinical outcome which showed excellent to good result.  </p><p class="abstract"><strong>Conclusions:</strong> Dual plating is ideal for all bicondylar Tibial plateau fracture of Schatzker type V and VI with appropriate timing of surgery and understanding the anatomy, LCP system, appropriate technique with dual incision, the complication can be minimized, giving excellent to good results.  </p>


Author(s):  
Siddaram N. Patil ◽  
Pandurangaiah Srinivas ◽  
Divya Bhandary

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Schatzker‘s type V and type VI fractures are bicondylar tibial plateau fractures which pose a challenge to the treating orthopaedician. Several studies have compared unilateral locked plate and double plating for their treatment and showed no statistically significant difference between these two fixation methods. So the quest for ideal implant for internal fixation (unilateral plating and dual plating) of these fractures continues. Hence we decided to do this study.</span></p><p class="abstract"><strong>Methods:</strong> A prospective study of Surgical Management of thirty seven cases of Schatzker’s type V and VI tibial plateau fractures by different types of plate osteosynthesis (single unilateral locking plate and dual incision locking buttress plate) was carried out. The functional outcomes were assessed by the hospital for special surgery knee score system.<strong></strong></p><p class="abstract"><strong>Results:</strong> 18 patients were fixed with a unilateral locking plate, 19 patients were fixed with a dual incision bilateral locking plates. All patients had satisfactory articular surface reduction and axis of alignment on immediate postoperative radiographs. All cases achieved union by 4.8 months approximately. All patients had either excellent or good HSS score. Mean HSS score at recent follow-up was 86.10 in DP group and 83 in SP groups (t value 2.81, p values 0.008)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> We conclude that single plating and dual plating fixation of complex proximal tibial plateau fracture Schatzker‘s type 5 and type 6 ensures stable fixation, immediate mobilization, satisfactory radiological outcome, very high union rates and excellent functional assessment outcome with a very low rate of complications<span lang="EN-IN">.</span></p>


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