TREATMENT OF COMPLEX TIBIAL FRACTURES TYPES V AND VI OF SCHATZKER CLASSIFICATION BY DOUBLE PLATE FIXATION WITH SINGLE ANTERIOR INCISION.

Corresponding Author:
Dr. M. N. Karthi,
Senior Assistant Professor, Department of Orthopaedics,
Madurai Medical College, Madurai, Tamilnadu.
E-mail: mn_karthi@yahoo.com

ABSTRACT

BACKGROUND

High velocity injuries of knee joint are always associated with complex proximal tibial fractures, Schatzker classification type V and VI and these fractures are always associated with high complication rates. There are various treatment modalities available for these fractures.

Aims and Objectives- To analyse the results of double plating with single anterior incision in complex proximal tibial fractures (Types V and VI of Schatzker classification).

MATERIALS AND METHODS

This case series of 30 patients (24 males and 6 females) with Types V and VI of Schatzker classification of proximal tibial fractures (12 cases were Type V and 24 cases were Type VI) were treated by double plating with single anterior incision method between Sep. 2012 and Aug. 2015. Functional and radiological outcome was assessed using Modified Rasmussen’s clinical and radiological criteria.

RESULTS

36 patients with tibial plateau fractures Schatzker type V and VI admitted at Government Rajaji Hospital, Madurai were included in this study. All the patients were treated with dual plating using single midline approach. The longest follow-up period was 20 months and shortest follow-up period was 6 months. Mean follow-up period was 14 months. Follow-up analysis was made using Modified Rasmussen’s Clinical and Radiological Criteria. In our study, 33.33% of the patients were in active productive age group (20 - 30 years). 83.33% of the patients were male. There was no significant difference in the side affected (Rt. side- 20 patients, Lt. side- 16 patients). All the patients in this study sustained injury due to road traffic accident. 66.7% of patients had Schatzker type VI fracture and 33.3% had Schatzker type V fracture. In this study 27.7% patients had excellent outcome, 52.77% patients had good outcome, 19.44% patients had fair outcome and none had poor outcome. In this study, only one patient developed deep infection with wound necrosis who was treated with IV antibiotics, debridement and flap cover was done and implant removal was done after 6 months. 4 patients with superficial infections were treated with antibiotics and regular dressing. One patient had mild valgus deformity, which did not interfere with her activities of daily living.

CONCLUSION

Single anterior midline approach and dual plating for tibial plateau fractures Schatzker type V and VI resulted in satisfactory clinical and radiological outcomes.

KEYWORDS

Tibial Plateau Fracture, Single Incision, Double Plate Osteosynthesis.