Abstract

Abstract Background: In spite of all the advances, tibial plateau fractures still pose a challenge to the orthopaedic surgeons due to the following reasons: presence of hinge joints at the knee and the ankle which allows no adjustment for rotatory deformity after fracture, occurrence of open fractures and higher rate of post-operative infection. The aim of surgical treatment of tibial plateau fractures is to restore congruent articular surfaces of the tibial condyles maintaining the mechanical axis and restoring ligamentous stability eventually can achieve functional painless and good range of motion in the knee joint. Materials and methods:Records of 53 knees in 38 men and 15 women aged 20 to 70 (mean, 37.9) years who underwent open reduction and internal fixation using a periarticular raft construct through a 3.5-mm locking plate without use of a bone graft or bone substitute for split-depression and depressed (>5 mm) proximal tibial plateau fractures (Schatzker type II and type III or AO/OTA type 41 B2 and B3). Out of the total 53 cases, 33 were of schaztkers type II while 20 cases were of type III who underwent the surgery between April 2016 and April 2018 at our institute were reviewed. Clinical and radiographic examinations were conducted in Follow-up at 1, 3 and 6 months. The Rasmussen radiological and clinical score, Lysholm knee score and Oxford knee score were assessed. Results: All patients achieved bone union after a mean of 12.87 (range, 8–24) weeks. The mean range of motion was 119.32º (range, 80º–135º). The Rasmussen radiological score was good to excellent in 48 cases while fair and poor outcome was seen in 4 and 1 cases respectively. The Rasmussen clinical score was good to excellent in 48 cases, while fair and poor outcome was seen in 4 and 1 cases respectively. As per Oxford Knee score, good to excellent outcome was obtained in 90.56% cases while fair and poor outcome was seen in 7.55% and 1.89% cases. As per Lysholm’s score, excellent and good outcome was obtained in 71.7% and 18.87% cases while fair and poor outcome was seen in 7.55% and 1.89% cases respectively. Conclusions:The stability of the internal fixation of proximal tibia fractures(Schatzker type II and type III or AO/OTA type 41 B2 and B3) after open reduction and internal fixation using a periarticular raft construct through a locking plate without use of a bone graft for split-depression tibial plateau fractures is a viable option

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