ABSTRACT
Background: Management of tibial plateau fractures remains challenging because of their number, variety and associated soft tissue injuries that further augment their complexity. proper management of the initial injury aims to obtain a stable, painless, mobile joint and to prevent the development of osteoarthritis. Anatomical restoration of articular surface and stable fixation are essential to achieve this goal. This study highlights the operative reduction and internal fixation of tibial plateau fractures and compare the results of fixation with only cannulated cancellous screws and plates. Methods: Institution based randomized, prospective, retrospective and observational study comprising of 30 patients attending Orthopaedics emergency or O.P.D. of age group 25-65 years with closed tibial plateau fractures. The outcome of treatment is assessed clinico-radiologically. Results: In our study we obtained overall excellent (76.2% cases) to good functional results (23.8% cases) by operative treatment with plate osteosynthesis for Tibial plateau fractures. All the patients treated with only cannulated cancellous screws had excellent functional outcome. Conclusion:The operative management of Tibial plateau fractures has definite advantages over conservative management. Percutaneous or open fixation using cannulated cancellous screws gives excellent functional results. But it is not suitable for severely depressed or comminuted fractures. Percutaneous and minimally invasive plate fixation method is more biological, requires less surgical time, less hospital stay, has minimum complications and has a good functional outcome. There is no ideal implant for these fractures, however, soft tissue handling is very important during surgery.