Functional outcome of Closed Schatzker Type V and VI Tibial Plateau Fractures managed by Open Reduction and Internal Fixation: A Prospective study

Abstract

Background: Tibial plateau fractures tend to occur in patients with polytrauma and in elderly patients with history of significant fall. This study was undertaken to evaluate and explore new generation implant fixation in tibial plateau fractures which is expected to provide a stable fixation with minimum exposure, early mobilization, less complications and a better quality of life.

Materials and Methods: About 45 cases who had sustained tibial plateau fractures (Schatzker type IVI) and managed by open reduction and internal fixation were included. Follow-up of these patients was done at 6 weeks, 3 months, and 6 months after surgery. We analyzed all our subjects using IKDC score for functional outcome and plateau depression measurement for radiological outcome at 3 months and 6 months.

Results: All the 45 fractures analyzed in this study were graded in accordance to the Schatzker classification. It was observed that most of these fractures, i.e., 17 out of 45 (37.2%) were type VI and 14 out of 45 (30.2%) type V. The average knee flexion at 3 months was 105.7±8.49 degrees and at 6 months 120.6±8.61 degrees. After evaluation, it was observed that at 6 months, 3 patients had extension lag (7%) out total 45 patients. Most of the patients had average IKDC score of 80.2±7.91% at 3 months which increased to average 86.92±8.05% at 6 months.

Conclusion: Achieving and maintaining anatomical reduction with open reduction and internal fixation helps in early mobilization and hence obtaining good functional and radiological outcomes of tibial plateau fractures type VI and type V.

Key words: Schatzker type IV and type V, Mippo plating, biological fixation, indirect reduction, tibial fracture damage.