Subchondral raft plate fixation for lateral tibial plateau fractures - A prospective study

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.