Comparative Analysis of Single Lateral Locked Plate and Double Locked Plate Application in the Treatment of Bicondylar Tibial Plateau Fractures

Abstract

Background and objective Bicondylar tibial plateau fractures (BTPFs) have been controversial in terms of surgery planning, due to articular joint surface comminution, severe soft tissue injury, and the risk of complications. The aim of this study was to conduct a clinical, functional, and radiologic comparison of the dual locked plate (DLP) and single lateral locked plate (SLLP) techniques. Methods Retrospectively analysed were 54 patients who underwent surgical treatment with DLP or SLLP due to the diagnosis of BTPFs, between January 2018 and June 2020. Patients were evaluated in the clinic with regard to their demographic characteristics, mechanisms of injury, follow-up periods, measurement of the range of motion degrees, functional scores, and radiographic parameters. The Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm Knee Score (Lysholm) and Oxford Knee Score (OKS) were chosen as the functional scores. The condylar width, medial proximal tibial angle (MPTA), posterior tibial slope (PTS) and fracture union time were calculated radiographically. Results The patients in the DLP group achieved significantly higher scores for all three scales when the KOOS, Lysholm, and OKS, respectively (P = 0.008, P = 0.048, P = 0.006), were compared. Radiographically, the mean increase in the condylar width of 1.72 mm in the DLP group and 2.59 mm in the SLLP group was measured (P = 0.010, P = 0.010, respectively). The mean decrease in MPTA was 1.75° in the DLP group and 3.54° in the SLLP group, which was statistically significant (P = 0.005, P = 0.001, respectively). An increase in the posterior tibial slope was measured at a mean of 1.8° in the DLP group and 1.4° in the SLLP group (P = 0.001, P = 0.008, respectively). On the other hand, when the condylar width, MPTA and PTS between the DLP and SLLP groups were compared, no significant difference was found (P = 0.179, P = 0.247, P = 0.611, respectively). Conclusion Better results were obtained in patients who underwent the DLP procedure when compared to those who had the SLLP. There was no radiographic difference between the two surgical procedures. Although DLP is an effective and reliable method in the treatment of BTPFs, the SLLP procedure also provides satisfactory results in patients with appropriate indications.