Evaluation of Subchondral Raft Construction without Bone Graft for Management of Split-Depression Tibial Plateau Fractures

Background: Split-depression tibial plateau fractures constitute the most prevalent type of tibial injury, accounting for twenty-five to thirty-three percent of all tibial plateau fractures. Utilizing a Kirschner wire, the subchondral raft technique is a well-known method for resisting depression and loss of reduction. Objectives: To assess the radiological and functional finding of split-depression tibial plateau fractures treated via subchondral raft screws combined with locking plates without bone graft and to describe the advantages and disadvantages of this technique. Patients and methods: This study was a prospective interventional that was performed on twenty-five cases aged between 18-60 years old of both sexes who had split-depression fractures of tibial plateau, admitted, and operated upon in Orthopedic Department of Suez Canal University Hospital (SCUH), Ismailia, Egypt. Results: There wasn’t statistically significant variance among the study population regarding age, gender, residency, comorbidities, flexion contracture, extension leg and range of flexion and Rasmussen radiological score at 2, 6 and 12 weeks follow up after the surgery, and complications. There was statistically significant improvement in the pain score among the study population with the follow up. There was statistically significant change in the depression score at 2, 6 and 12 weeks follow up after the surgery. Conclusion: One of the best ways to fix split-depression and isolated depression tibial plateau fractures is with a periarticular rafting screw, which doesn't need bone grafts or bone replacements. This can be done during open reduction and internal fixation.