A Study of Functional Outcome of Tibial Plateau Fractures Managed with Bicondylar Plating

Abstract

Introduction: Tibial plateau fractures represent complex orthopedic injuries with significant implications for knee function and mobility. Their management is challenging due to the fractures’ impact on the weight-bearing surface of the knee joint. Recent advancements, including bicondylar plating techniques, aim to restore joint integrity and ensure optimal functional outcomes. This study focuses on evaluating the clinical, radiological, and functional outcomes of high-velocity tibial plateau fractures managed surgically with bicondylar plating. Methodology: This retrospective cohort study was conducted at a tertiary care center from March 2022 to September 2023, involving 41 patients. Inclusion criteria were patients aged 20–60 years with high-velocity tibial plateau fractures having >2 mm articular surface depression/displacement. Exclusion criteria included open fractures, pathological fractures, pre-existing joint diseases, and neurovascular injuries. All patients underwent surgical management via open reduction and internal fixation with bicondylar plating. Clinical, radiological, and functional evaluations were conducted using tools like the Knee Society Score (KSS) and radiographic assessments. Data were statistically analyzed to explore relationships between fracture type, surgical intervention quality, and functional outcomes. Results: The study demonstrated satisfactory outcomes in 88% of cases, with most patients regaining near-normal knee function. Radiological assessments revealed excellent alignment and union rates, with an average union time of 12 weeks. Functional evaluations using the Lysholm and Tegner activity scores indicated good to excellent results in a majority of patients, with only 12% reporting chronic pain. Common complications included infection (20%), requiring additional interventions like debridement and implant removal, and malalignment in 5% of cases. These complications were predominantly associated with severe fractures or non-compliance with post-operative protocols. Early mobilization and physiotherapy played a crucial role in enhancing recovery. Conclusion: The surgical management of high-velocity tibial plateau fractures with bicondylar plating demonstrates significant efficacy in achieving anatomical reduction, stable fixation, and optimal functional recovery. While complications such as infection and malalignment pose challenges, meticulous surgical techniques, tailored rehabilitation protocols, and careful patient selection minimize these risks. The findings reinforce bicondylar plating as a robust approach for managing complex tibial plateau fractures, contributing to enhanced patient outcomes and quality of life.