Displaced Tibial Plateau Fractures: Is There A Role Of Conservative Treatment In The Present Scenario.

ABSTRACT

This retrospective case series includes 92 closed tibial plateau fractures treated by operative (66 patients) and conservative (26 patients) methods at our institution.The means and mean differences of grades of the objective variables of extensor lag and range of motion and articular step were better in the surgically treated patients (p value <0.05), while those of axial alignment and side to side instability did not show any statistical significance. An average articular step of more than 1.6 mm significantly deteriorated the functional outcome.Achieving articular congruity is the most important factor for the successful outcome of tibial plateau fractures. Operative treatment in the presence of adequate expertise and infrastructure gives satisfactory results. Type V and VI fractures are highly unstable fractures and need to be treated by more stable fixation in the form of dual plating and/or locked compression plating. The variables like extensor lag, range of motion and radiological articular step directly correlate with the functional outcome of tibial plateau fractures. The conservative treatment should only be accepted as last option in case of displaced tibial plateau fractures.