Osteosynthesis of Schatzker's Type II and Type III Lateral Tibial Condyle Fracture With or Without Bone Graft-A Clinical and Radiological Prospective Study.

Abstract

Background: Tibial plateau fractures can indeed be quite complex, and their management is critical for ensuring optimal outcomes. The management of subchondral cavities following the elevation of depressed plateau fragments is challenging. There are various options to manage the defect, autologous cortico-cancellous bone transfer, bone graft substitutes, and modification of internal fixation techniques in order to minimize the degree of subchondral collapse and articular incongruity.

Materials and methodology: A longitudinal prospective study was conducted at our institute. All patients with closed Schatzker type 2 and 3 tibial plateau fractures with articular depression <20 mm were alternatively assigned into two groups, by matching fracture types. Without bone graft, the group underwent treatment in the form of open reduction and plating for lateral condyle fracture. The bone graft group underwent additional bone grafting apart from plating. Each group had 20 patients. Patients were followed at regular intervals of 1 month, 3 months, 6 months, 12 months, and until fracture union.

Results: By comparing our results between the two groups, we found that there was no significant difference between groups with and without bone grafting for internal fixation of depressed <20 mm type II and type III tibial plateau fractures. The functional and radiological outcomes, time to union, and complication rates were similar in the two groups, and there was no statistically significant difference between the groups.

Conclusion: For osteosynthesis of depressed tibial plateau fractures, Schatzker type 2 and type 3 with depression of <20 mm, internal fixation without bone graft is a viable option. There is no statistically significant difference in functional and radiological outcomes between bone grafting and non bone grafting group.