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

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Abstract

Background: Bicondylartibial 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, howeverthere 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.

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References

  1. Higgins TF, Klatt J, Bachus KN. Biomechanical analysis of bicondylar tibial plateau fixation: How does lateral locking plate fixation compare to dual plate fixation? J Orthop Trauma 2007;21:301–6.

    Article  Google Scholar 

  2. Gosling T, Schandelmaier P, Marti A, Hufner T, Partenheimer A, Krettek C. Less invasive stabilization of complex tibial plateau fractures: A biomechanical evaluation of a unilateral locked screw plate and double plating. J Orthop Trauma 2004;18:546–51.

    Article  CAS  Google Scholar 

  3. Jiang R, Luo CF, Wang MC, Yang TY, Zeng BF. A comparative study of less invasive stabilization system (LISS) fixation and two-incision double plating for the treatment of bicondylar tibial plateau fractures. Knee 2008;15:139–43.

    Article  Google Scholar 

  4. Moore TM, Patzakis MJ, Harvey JP. Tibial plateau fractures: Definition, demographics, treatment rationale, and long term results of closed traction management or operative reduction. J Orthop Trauma 1987;1:97–119.

    Article  CAS  Google Scholar 

  5. Catagni MA, Ottaviani G, Maggioni M. Treatment strategies for complex fractures of the tibial plateau with external circular fixation and limited internal fixation. JTrauma 2007;63:1043–53.

    Google Scholar 

  6. Gaudinez RF, Mallik AR, Szporn M. Hybrid external fixation of comminuted tibial plateau fractures. Clin Orthop Relat Res 1996;328:203–10.

    Article  Google Scholar 

  7. Dendrinos GK, Kontos S, Katsenis D, Dalas A. Treatment of high-energy tibial plateau fractures by the Ilizarov circular fixator. J Bone Joint Surg Br 1996;78:710–7.

    Article  CAS  Google Scholar 

  8. Ballmer FT, Hertel R, Nötzli HP. Treatment of tibial plateau fractures with small fragment internal fixation: A preliminary report. J Orthop Trauma 2000;14:467–74.

    Article  CAS  Google Scholar 

  9. Horwitz DS, Bachus KN, Craig MA, Peters CL. A biomechanical analysis of internal fixation of complex tibial plateau fractures. J Orthop Trauma 1999;13:545–9.

    Article  CAS  Google Scholar 

  10. Watson JT. Tibia: Proximal. In: Riiedi TP, Murphy WM, editors. AO Principles of Fracture Management. Stuttgart: Thieme; 2000. p. 499–517.

    Google Scholar 

  11. Yoo BJ, Beingessner DM, Barei DP. Stabilization of the posteromedial fragment in bicondylar tibial plateau fractures: A mechanical comparison of locking and nonlocking single and dual plating methods. J Trauma 2010;69:148–55.

    Article  Google Scholar 

  12. Barei DP, O’Mara TJ, Taitsman LA, Dunbar RP, Nork SE. Frequency and fracture morphology of the posteromedial fragment in bicondylar tibial plateau fracture patterns. J Orthop Trauma 2008;22:176–82.

    Article  Google Scholar 

  13. Young MJ, Barrack RL. Complications of internal fixation of tibial plateau fractures. Orthop Rev 1994;23:149–54.

    CAS  PubMed  Google Scholar 

  14. Barei DP, Nork SE, Mills WJ, Henley MB, Benirschke SK. Complications associated with internal fixation of high-energy bicondylar tibial plateau fractures utilizing a two-incision technique. J Orthop Trauma 2004;18:649–57.

    Article  Google Scholar 

  15. Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, et al. Fracture and dislocation classification compendium-2007: Orthopaedic trauma association classification, database and outcomes committee. J Orthop Trauma 2007;21 10 Suppl: S1–133.

    Article  Google Scholar 

  16. Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: Retrospective and prospective analyses. J Bone Joint Surg Am 1976;58:453–8.

    Article  CAS  Google Scholar 

  17. Oestern HJ, Tscherne H. Pathophysiology and classification of soft tissue injuries associated with fractures. In: Tscherne H, Gotzen L, editors. Fractures with Soft Tissue Injuries. Berlin: Springer Verlag; 1984. p. 1–9.

    Google Scholar 

  18. Fakler JK, Ryzewicz M, Hartshorn C, Morgan SJ, Stahel PF, Smith WR. Optimizing the management of Moore type 1 postero-medial split fracture dislocations of the tibial head: Description of the Lobenhoffer approach. J Orthop Trauma 2007;21:330–6.

    Article  Google Scholar 

  19. Paley D, Herzenberg JE, Tetsworth K, McKie J, Bhave A. Deformity planning for frontal and sagittal plane corrective osteotomies. Orthop Clin North Am 1994;25:425–65.

    CAS  PubMed  Google Scholar 

  20. Stevens DG, Beharry R, McKee MD, Waddell JP, Schemitsch EH. The long term functional outcome of operatively treated tibial plateau fractures. J Orthop Trauma 2001;15:312–20.

    Article  CAS  Google Scholar 

  21. Egol KA, Su E, Tejwani NC, Sims SH, Kummer FJ, Koval KJ. Treatment of complex tibial plateau fractures using the less invasive stabilization system plate: Clinical experience and a laboratory comparison with double plating. J Trauma 2004;57:340–6.

    Article  Google Scholar 

  22. Phisitkul P, McKinley TO, Nepola JV, Marsh JL. Complications of locking plate fixation in complex proximal tibia injuries. J Orthop Trauma 2007;21:83–91.

    Article  Google Scholar 

  23. Zhang Y, Fan DG, Ma BA, Sun SG. Treatment of complicated tibial plateau fractures with dual plating via a 2-incision technique. Orthopedics 2012;35:e359–64.

    PubMed  Google Scholar 

  24. Gosling T, Schandelmaier P, Muller M, Hankemeier S, Wagner M, Krettek C. Single lateral locked screw plating of bicondylar tibial plateau fractures. Clin Orthop Relat Res 2005;439:207–14.

    Article  CAS  Google Scholar 

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Correspondence to Chandra Shekhar Yadav.

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Neogi, D.S., Trikha, V., Mishra, K.K. et al. Comparative study of single lateral locked plating versus double plating in type C bicondylar tibial plateau fractures. IJOO 49, 193–198 (2015). https://doi.org/10.4103/0019-5413.152478

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