Introduction: Tibial plateau fractures are often complex fractures that are difficult to stabilize. Subchondral raft technique is used to prevent depression and reduction loss using Kirschner wires, lag screws or locking screws with or without plates. The study aimed to assess the functional outcome of lateral tibial plateau fractures fixed with raft plate and the associated complications. Materials and methods: A prospective observational study of 45 consecutive patients with depressed lateral tibial plateau fractures treated with raft plate were studied at a tertiary care centre for a period of one year. Patients were followed up for a minimum period of 6 months. The Lysholm Knee Scoring Scale (LKSS) was used to assess the functional outcomes. Results: The mean age of the patients was 43.8 ± 10.54 years (range 18-60 years). Male- Female ratio was 2.75:1 (M=33, F=12). Proportion of type II Schatzker fractures was 44.4%. 35 patients (77.8%) sustained injury due to road traffic accident and the rest due to fall. Bone grafting was done in 18 patients (40%). Knee stiffness and flexion less than 95⁰ were noted in 5 patients (11.1%). Superficial wound infection was noted in 2 patients (4.4%). Knee pain was observed in 7 patients (15.6%). Conclusion: Laterally placed raft plate with periarticular locking screws through it offers an excellent method of fixation of tibial plateau fractures, which preserves the anatomical joint line and the normal mechanical axis with minimal complications. Raft plating may obviate the need for dual plating in most of the tibial plateau fractures.

Background: Surgical treatment is often needed for Charcot neuroarthropathy (CN) of foot. Even though good outcomes were reported with tibiotalocalcaneal arthrodesis (TTCA) in CN patients, the choice of implant is still an issue. The aim of the study was to evaluate the outcomes of TTCA with retrograde intramedullary nail, in patients with CN. Materials and methods: A prospective observational study was done with 41 consecutive patients treated with TTCA with hindfoot retrograde IM nail. The American Orthopaedic Foot and Ankle Society (AOFAS) score was used for the outcome evaluation, one year after surgery. Results: The mean age was 67.4(±8.7) years, with 63.5% females. Most common cause was diabetes mellitus (75.6%), followed by post-traumatic CN (19.5%) and chronic alcoholism (4.9%). Eleven (26.8%) had good score at the end of 1 year compared to five (12.2%) pre-op and twenty (48.8%) had fair score compared to fifteen (36.6%). The AOFAS score increased one year after surgery (p value 0.001). In twenty (48.8%) patients, the time taken for union was more than 6 months; and in 15 (36.6%) union occurred within 6 months of surgery. Six (14.6%) patients had non-union. Two (4.9%) had deep infection along with non-union. Hardware failure was seen in 3 (7.3%) patients. Hardware failure with non-union was reported in one (2.4%). Four (9.8%) patients had superficial wound infection and amputation done in one (2.4%) patient. Conclusion: Tibiotalocalcaneal arthrodesis with retrograde intramedullary nail is an acceptable and safe procedure with good clinical outcomes in patients with Charcot arthropathy which obviates the need for amputation. Keywords: Charcot neuroarthropathy; tibiotalocalcaneal arthrodesis; intramedullary nail; amputation