Management of tibial condylar fractures in adults: A prospective study

Abstract

Tibial condylar fractures are specially challenging to the Orthopaedic surgeons because of their variation, complexity, and injuries associated with it. Proximal tibia gives attachment to the various elements of knee stabilizers and is an integral part of the knee mechanism. So, alteration of its anatomy caused by injury result in functional impairment of knee. A study has been carried out to know the mode of injury, fracture pattern, outcome of various modalities of treatment, complications encountered and associated with management of tibial condylar fractures in adults. Study consists of 35 patients with tibial condylar fractures. Out of 35 patients, 12 patients were managed by conservative methods and remaining 23 Patients were managed by surgical methods. Conservative treatment included closed reduction and above knee cast application and surgical management included CRIF with CCS or ORIF with BP with or without bone grafts. Functional evaluation of the knee was done, based on the modified HohI and Luck evaluation methods. Incidence of osteoarthritis was assessed based on the most recent radiograph of tile patient's weight bearing. The management of tibial plateau fracture has always been a subject of debate because of their variety and complexity. It is concluded that surgery is the treatment of choice for displaced fractures belonging to Schatzker type I and II. Schatzker's type III fractures can be managed conservatively if the depression is less than 2 mm. Schatzker's type IV and V can be managed by open reduction and internal fixation with Buttress plate and bone grafting especially in young individuals who require perfect anatomical reconstruction of the articular surface, stable fixation and early mobilization. Conservative method is a valid and useful alternative for undisplaced Schatzker type I fractures.