Dual Plating in Bicondylar Proximal Tibia Fractures and Its Functional Outcomes

TL;DR

This study evaluates the effectiveness of dual plating in treating complex tibia fractures, focusing on recovery outcomes like knee mobility and healing time.

Contribution

The study introduces dual plating with locking plates as a novel method for treating bicondylar proximal tibia fractures.

Findings

Mean time to fracture union was 3.81 ± 0.82 months.

Mean knee range of motion was 134.5 ± 11.09 degrees.

16.67% of patients experienced complications.

Abstract

Background: Managing such fractures is a difficult challenge in developing countries. Many kinds of internal fixation devices, including recently developed plates with screws, have been applied to treat these complex fractures. In this study, dual plating of bicondylar proximal tibia fractures is done to assess the outcome of the patients in terms of knee range of motion, fracture union, and reduction, which dictates the functional outcome.

Materials and methods: A prospective study was carried out to assess the outcomes of proximal tibial fractures in the department of orthopaedics from May 2022 to April 2025. A total of 30 patients with bicondylar proximal tibia fractures were operated on. The patients were monitored for an average of six months. Data were entered into a spreadsheet and analyzed using descriptive statistics. Continuous variables were expressed as mean ± standard deviation, while categorical variables were summarized as frequencies and percentages.

Result: Mean time to fracture union was 3.81 ± 0.82 months. The mean range of motion of the knee joint was 134.5 ± 11.09 degrees (range: 0° to 10° for extension and range: 0° to 120°-150° for flexion). At the last follow-up, the mean Rasmussen's functional grading score was 27.96 ± 2.95. Five (16.67)% patients in the current study experienced complications.

Conclusion: Rigid and stable fixation with proper articular reduction, maintaining the soft tissue integrity, is the most important determinant for outcome in the treatment of Schatzker V and VI proximal tibia fractures, which can be achieved with bi-column fixation with locking plates using the dual approach.

Figures