Mid-term Comparative Analysis of Orthogonal Versus Parallel Plating in Bicondylar Tibial Plateau Fracture

Abstract

Background: Proximal tibial plateau involvement is one of the most common intra-articular fractures. Bicondylar fractures have both tibial plateaus fractures, usually with depressed fracture of lateral tibial plateaus, meniscal tears and anterior cruciate ligament avulsions. Internal fixation in bicondylar proximal tibia fractures using plating devices are usually done using lateral plate along with supplementary postero-medial plate (orthogonal plating) and lateral plate along with medial plate (parallel plating). Objectives: The comparison of functional and radiological outcomes. Materials and Methods: 60 cases of bicondylar tibia plateau fracture were included. Group A (orthogonal plating) were cases treated with orthogonal plating and Group B (parallel plating) were cases those treated with parallel plating. A clinic-radiological comparison of results of these two groups were done. Clinical evaluation for at least 6 months and radiographically for at least 1 year. Results: Our clinico-radiological result showed that knee range of motion (mean) (P = 0.002) and Hip-Knee-Ankle angle (HKA) were significantly better in group B while non-significant difference in Varus/valgus angulation, fracture union status, post-operative loss of reduction and residual articular surface depression, implant position and other surgery or implant related complications. Conclusions: Our mid-term results showed that treating above fractures with parallel plate resulted in better functional and radiological outcomes with an acceptable complication rate as compared to orthogonal plate