Functional outcome of tibial plateau fractures treated with locking compression plates

Introduction and Objectives: Tibial plateau fractures are one of the most common fractures around the knee joint and cases are increasing due to high number of vehicular accidents. Because of the involvement of the knee joint, restoration of articular congruity is of prime importance since knee joint is main weight bearing joint of the body. The new generation locking plates have an edge over regular buttress plates by overcoming few of the limitations of these plates. Locking plates can be used in a biological fixation manner, there by promoting secondary bone healing and faster healing also. Materials and Methods: A total of sixty three patients with tibial plateau fractures were included in the study who were operated between June 2014 to June 2017. Out of the sixty three patients, forty eight patients were operated using conventional open reduction method and fixed with locking compression plate, whereas fifteen patients under went internal fixation by minimally invasive technique. Results: All patients were followed up till complete union of the fracture. Average follow up period ranged from 16 to 24 weeks. All the fractures went for union in an average period of 18 weeks and the time for union ranged from 16 to 24 weeks. Those patients in whom fracture was fixed in a biological manner using minimally invasive technique went in for early union compared to patients treated by open reduction techniques. We used oxford criteria for the evaluation of clinical results. We had excellent results in thirty three, good results in twenty one patients, fair results in six patients and poor results in a total of three cases. We had 6 patients with knee joint stiffness, 3 infections, 3 with varus deformity and 3 cases of knee instability. There were no cases of implant failure or implant related complication in our case series. Conclusion:Majority of the tibial plateau fractures in our series were a result of road traffic accidents. In patients whom fractures were fixed by minimally invasive technique fracture went in for early union when compared to fractures treated by open reduction technique. The advent of locking compression plates have brought in a lot of advantage over conventional plating systems in that the operative time is less, blood supply to fracture is preserved and soft tissue is preserved. However, a long learning curve and technical skills are required for doing locking plate fixations.