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. 2015 Mar-Apr;49(2):193-8.
doi: 10.4103/0019-5413.152478.

Comparative study of single lateral locked plating versus double plating in type C bicondylar tibial plateau fractures

Devdatta Suhas Neogi  1 , Vivek Trikha  2 , Kaushal Kant Mishra  2 , Shivanand M Bandekar  3 , Chandra Shekhar Yadav  2
Affiliations

Comparative study of single lateral locked plating versus double plating in type C bicondylar tibial plateau fractures

Devdatta Suhas Neogi et al. Indian J Orthop. 2015 Mar-Apr.

Abstract

Background: Bicondylar tibial plateau fractures are complex injuries and treatment is challenging. Ideal method is still controversial with risk of unsatisfactory results if not treated properly. Many different techniques of internal and external fixation are used. This study compares the clinical results in single locked plating versus dual plating (DP) using two incision approaches. Our hypothesis was that DP leads to less collapse and change in alignment at final followup compared with single plating.

Materials and methods: 61 cases of Type C tibial plateau fractures operated between January 2007 and June 2011 were included in this prospective study. All cases were operated either by single lateral locked plate by anterolateral approach or double plating through double incision. All cases were followed for a minimum of 24 months radiologically and clinically. The statistical analysis was performed using software SPSS 10.0 to analyze the data.

Results: Twenty nine patients in a single lateral locked plate and 32 patients in a double plating group were followed for minimum 2 years. All fractures healed, however there was a significant incidence of malalignment in the single lateral plating group. Though there was a significant increase in soft tissue issues with the double plating group; however, there was only 3.12% incidence of deep infection. There was no significant difference in Hospital for special surgery score at 2 years followup.

Conclusion: Double plating through two incisions resulted in a better limb alignment and joint reduction with an acceptable soft tissue complication rate.

Keywords: Tibial fracture; Tibial plateau fracture; bicondylar fracture; bone plates; knee; locking plate.

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Conflict of interest statement

Conflict of Interest: None.

Figures

Figure 1A
Figure 1A
(a) X-rays of knee joints anteroposterior and lateral views (b) Computed tomography scan coronal images showing Type C bicondylar tibial plateau fractures
Figure 1B
Figure 1B
X-rays of knee joints anteroposterior and lateral views (a) immediate postoperative (b) 2 years followup showing double plating and tibial plateau at right angle to tibial axis. (c) Clinical photographs at 2 years followup showing range of motion
Figure 2
Figure 2
X-ray of knee joint with leg bones anteroposterior view (a) immediate postoperative (b) 2 years followup showing single locking plate and change in axis at followup
See this image and copyright information in PMC

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