COMPARATIVE STUDY OF FUNCTIONAL OUTCOME OF UNILATERAL LOCKING PLATE AND DUAL PLATING IN THE TREATMENT OF BICONDYLAR  PROXIMAL TIBIA FRACTURES

Krishna Prasad.N; Joginath.B; Nanda Gopal.V; Sreenivasa Chowdary.J

Volume : VII, Issue : II, February - 2017

COMPARATIVE STUDY OF FUNCTIONAL OUTCOME OF UNILATERAL LOCKING PLATE AND DUAL PLATING IN THE TREATMENT OF BICONDYLAR PROXIMAL TIBIA FRACTURES

Krishna Prasad. N, Joginath. B, Nanda Gopal. V, Sreenivasa Chowdary. J

Abstract :

Background

Proximal Tibia Fracture (PTF) includes different fracture patterns with varied degrees of articular depression and displacement. Many kinds of fixators, including newly designed plate with locking screws were applied to treat these complicated fractures. We intended to follow up the surgical outcomes of 1. Unilateral locking plate and 2.Classic dual plates.

Materials and methods

We retrospectively reviewed 66 patients with PTF, Schatzker types V and VI, who we operated in our institute. Excluding patients who expired due to other medical conditions and without complete follow–up. The scheme of surgical intervention was designed by visiting staff, and 15 patients, as Group I, were treated with unilateral locking plate. The other 19 patients, as Group II, were treated with classic dual plates (one lateral approach locking compression plate (LCP) + medial anti–gliding plate). All patients were under periodic follow up at about 6 weeks interval for at least 18 months postoperatively.

Results

In Group I, 11 cases achieved solid bony union without obvious traumatic OA change, limitation of ROM, or malalignment. In Group II ,17 patients reached the same goal, respectively. By analysis of the recorded parameters with statistical software (SPSS 12.0), there were five parameters with significant difference, including Schatzker classification, Operation time, Staged treatment done or not done, Period of hospitalization and Hardware impingement.

Conclusion

Our study shows Dual plating provides better stability and outcome than unilateral plate fixation for Schatzker type V and type VI fractures. On clinical follow up one should keep a close eye on soft tissue problems and post operative malalignment. To understand the role of CT scan in pre–op planning in bicondylar fractures.