Prospective study of management of Schatzker’s type V & VI tibial plateau fractures by different types of plate osteosynthesis

Abstract

Background: 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. Methods: 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. Results: 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). Conclusions: 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.