A Novel Technique of Biological Osteosynthesis in a Bicondylar Tibial Fracture

Abstract

Purpose: To evaluate the biological treatment outcomes for tibial plateau fractures. Methods: 8 men and 4 women aged 21 to 54 (mean, 36) years with closed tibial plateau fractures were enrolled for the study. According to the Schatzker classification, patients were classified into type I (n=1), type II (n=2), type IV (n=4), and type V (n=5). After closed reduction the fracture was fixed with two to three 6.5 mm cannulated cancellous screws and crossed K wires.The functional outcome was evaluated using the Rasmussen score. A total score of 28 to 36 was considered as excellent, 20 to 27 as good, and less than 10 as poor. Results: Patients were followed up for a mean of 2.2 (range, 1-3.4) years. All the fracture united radiographically after a mean of 3 (range, 2.3-4.3) months. Respectively in Schatzker types-I, II, IV, and V fractures, outcomes were excellent in 1, 2, 3, and 3 patients, It was good in 0, 0, 1, and 1 patients, fair in 0, 0, 0, and 1 patient, and poor in 0, 0, 0, and 0 patients. Outcome was satisfactory (good-to-excellent) in 85%, 86%, 100%, and 80% of the respective fracture types of patients. The mean Rasmussen score was 26.7 for all patients; it was 27.7 for type I, 26.5 for type II, 28.9 for type IV, and 24.4 for type V fractures. No infection, wound dehiscence or hardware issues were noted. Conclusion: This technique offers improved fracture healing without any risk of soft tissue complications, minimising the hospital stay and expenditure.