A Compartive analysis of functional outcome of tibial plateau fractures treated with proximal tibial locking plate with raft screw technique and conventional buttress plating

BACKGROUND AND OBJECTIVE: Fractures of the tibial plateau range from simple lateral condyle fracture to severe comminuted metaphyseal fractures associated with varying degrees of articular depression. Management of these complicated fractures remains challenging. The aim of this study is to compare the functional outcome of tibial plateau fractures treated with proximal locking plate with raft screws (raft plating) and conventional buttress plating. MATERIALS AND METHODS: Our study was a prospective cum retrospective study, conducted at the Institute of Orthopaedics and Traumatology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai between July 2013 to September 2014. Patients admitted with tibial plateau fractures (type II to VI Schatzker) were divided into two groups of 10 each. One group was treated with raft plating and another with buttress plating. They were followed for a period of 6 months. Functional outcome was assessed by knee society score devised by the hospital for special surgery. RESULTS: In raft plating group, 7 patients had excellent results, 2 had good results and 1 had fair result. In buttress plating group, 2 had excellent results, 2 had good results, 5 had fair results and 1 had poor result. The mean knee society score in the raft plating group was 84.8 and in the buttress plating group, it was 71.6. By analysis of the results, there was statistically significant difference in the functional outcome of patients treated by raft plating compared to buttress plating. CONCLUSION: Raft plating prevents the late subsidience of articular surface and hence better functional outcome. From this study, it can be concluded that when compared to buttress plating, raft plating is a better and effective method for achieving good to excellent results providing almost full range of motion and maintaining articular congruity in the treatment of tibial plateau fractures