Indian Journal of Public Health Research & Development

Comminution of articular surfaces and metaphyseal region, extensive soft tissue injuries, infection and risk of compartment syndrome are the challenging factors in management of Tibial Plateau Fractures. Various modalities like cast, traction, external fixation and open reduction and internal fixation with plating are the available options for treating such complex fractures. In this study we prospectively analysed the functional outcome of fixation of tibial plateau fractures based on Luo et al's “Three-Column Concept” fracture classification.

In this study, twenty patients with complex ‘’three-column tibial plateau fracture’’ were followed up prospectively clinically and radiologically for a duration of 6 months. After an initial conservative management all patients underwent buttress and supporting multiple plate fixation depending on the specific column involvement of proximal tibia. Final outcome assessment was done with IKDC 2000 & Functional and Subjective Knee society score (KSS) based on functional outcome, fracture union, articular congruity and deformities, if any.

90% (18/20) of patients showed excellent results according to objective and subjective knee society scoring, whereas 10% (2/20) developed complications postoperatively.

The results of this study concluded that multiple plate stabilization of complex “three-column tibial plateau fracture’’ is an excellent modality of treatment with minimal complication rate, of these otherwise difficult to manage fractures with other traditional methods.