# Functional Outcomes of Posterior Plate Fixation in Complex Tibial Plateau Fractures: A Retrospective Study

## TL;DR

This study evaluates the effectiveness of posterior plate fixation for complex tibial plateau fractures, showing good healing and functional outcomes with low complications.

## Contribution

The study provides empirical evidence on the long-term functional and radiological outcomes of posterior plate fixation for complex tibial plateau fractures.

## Key findings

- Posterior plate fixation achieved radiological union in all 30 patients with a mean healing time of 16.2 weeks.
- Excellent articular congruity was achieved in 96.6% of cases, with low complication rates and no implant failures.
- Patients achieved independent ambulation at a mean of 18.1 weeks, with good knee function scores.

## Abstract

Aim

The research aimed to assess the functional and radiological results of posterior plate fixation in complex types of posterior tibial plateau fractures (PTPFs) with special regard to the stability of the region, healing of the fractures, and the patient's functioning several years after surgery.

Materials and methods

An exhaustive study of the concerned group of patients was done on 30 individuals who underwent posterior plate fixation for closed PTPFs at the Department of Orthopaedics and Traumatology, Peerless Hospital and B.K. Roy Research Centre, Kolkata, India, from September 2018 to March 2021. A thorough clinical and radiological follow-up was carried out for every patient at set periods of time, before and after the operation. After a thorough study, key outcome metrics were measured, such as duration of fracture union, articular congruity, Knee Society Scores (KSS), International Knee Documentation Committee (IKDC) scores, range of motion (ROM) of the knee, and complications.

Results

The study included 30 participants, with a mean age of 40.70 ± 8.46 years. These included 25 males and 5 females. All fractures showed radiological union after a mean of 16.2 ± 3.1 weeks. Excellent articular congruity (≤2 mm step-off) was achieved in 29 (96.6%) cases. The mean clinical and functional KSS was 85.60 ± 7.09 and 81.23 ± 6.09, respectively; the mean IKDC score was 70.83 ± 6.92. Mean knee flexion achieved was 122.60° ± 8.08°, and all patients achieved independent ambulation at a mean of 18.1 ± 2.6 weeks. Complications managed conservatively included superficial infection in three (10%) patients and knee stiffness in four (13.3%) patients.

Conclusion

Posterior plate fixation has proven to be simple and effective, achieving excellent radiological and functional outcomes. Patients were able to gain early movement and independent walking by the final follow-up, with all patients having stable fixation. The technique was reliable, with low complication rates and no implant failures or nonunion, and was an effective surgical treatment for complex PTPFs.