Outcomes of Bi-Columnar Plating in the Treatment of Proximal Tibia Fractures: A Focus on Schatzker Types V and VI

Introduction: Controversy still surrounds the fixation of comminuted bicondylar tibial plateau fractures. Several fixation methods could be used for tibial plateau fractures. All of these techniques have strengths and weaknesses and there is no clear consensus on which leads to the best outcomes. We describe the effectiveness of Bicolumnar plating for proximal tibia fractures of Schatzker type V and VI. Materials & Methods: This is a prospective study conducted with proximal tibial fractures: Schatzker type V & type VI. All patients underwent bicolumnar plating of proximal tibia. All patients were postoperatively assessed for functional outcome using the Knee Society Score and radiological outcomes by Modified Rasmussen scoring criteria. Results: 21 Cases were operated with mean age of 43 years. The mean time for fracture union was 4 months (16 weeks). The mean knee flexion in this study group was 120.67 degrees. 17 patients had excellent functional and objective knee score and 4 patients had good functional and objective knee score. None of the patients had fair or bad scoring Discussion: A double incision Double plating technique is recommended by the Association for Osteosynthesis/Association for the Study of Internal Fixation for the treatment of complex tibial plateau fractures. . In our study, all fractures united within expected time with average time of 15-16 weeks. In our series, mean flexion at the knee joint was 120.67 degrees. But our follow up duration was only of 2 years and long term follow up of at least 6-8 years is required for diagnosis of secondary osteoarthritis. . Age, fracture union, objective and functional knee society score outcome have an effect on final radiological outcome. Lesser the age of patient, better is the radiological outcome. Conclusion: Medial and lateral plate stabilization of comminuted bicondylar tibial plateau fractures through medial and lateral surgical approaches is a superior treatment method; however, residual dysfunction is common.