Surgical Management of Split Depression Fracture of The Lateral Tibial Plateau

Abstract

Background: Tibial plateau fractures are one of the commonest intra-articular fractures resulting from indirect coronal or direct axial compressive forces. Fractures of tibial plateau constitute 1% of all fractures and 8% of fractures in the elderly.
Objective: In the present study, we aimed to prevent the development of osteoarthritis and to correlate the radiological findings with this type of tibial plateau fracture.
Patients and methods: This study was an interventional study, where 18 patients were conducted with tibial plateau fracture Schatzker type 2 and were operated in the Department of Orthopedics, Faculty of Medicine, at Zagazig University Hospital.
Results: Most of cases (55.6%) were operated upon 2 days after occurrence of fracture, followed by 27.8%, 16.6% were operated upon after 7 days and 10 days respectively. Seventeen (94.4%) cases were fixed by buttress plate while 1 case (5.6%) was fixed by proximal tibial plate and 16 cases (88.9%) needed bone graft. Significant improvement in time regard function score (knee society score) and radiological score (Rasmussen Assessment score) were found. No complication was found in 66.7% of studied group; 16.7% had infection, 11.1% had valgus deformity and only one case 5.6% had stiffness.
Conclusion: It could be concluded that the surgical management of tibial plateau fractures is challenging and gives excellent anatomical reduction and rigid fixation to restore articular congruity, facilitate early knee motion by reducing post-traumatic osteoarthritis and thus achieving optimal knee function.