Functional outcomes of bicondylar tibial plateau fractures treated with dual buttress plates and risk factors: a case series.

OBJECTIVE

Although there are different ways to treat bicondylar tibial plateau fractures, treatment remains as a challenge to most orthopaedic surgeons. The purpose of this study was to assess the outcomes of dual buttress plates fixation in treatment of bicondylar tibial plateau fractures and to determine risk factors for outcome.

METHODS

Clinical data for 74 patients with bicondylar tibial plateau fracture were retrospectively reviewed. Dual buttress plates were placed through two incisions. All patients were evaluated both radiographically and clinically according to Rasmussen scores and Hospital for Special Surgery (HSS) scores during the follow-up period. The data were analyzed using univariate analysis and multivariate logistic regression analysis to identify independent risk factors for functional outcome (Rasmussen functional score).

RESULTS

Rasmussen anatomic score was excellent in 34, good in 23, and fair in 17 patients. Sixty-nine patients were followed for a mean of 27 months. Functional results of excellent and good were obtained in 56(81.2%) patients by Rasmussen functional score and in 57 (82.6%) patients by HSS score. Univariate analysis showed Arbeitsgemeinschaft für Osteosynthesefragen (AO) fracture type and reduction quality were significantly related to functional results. Multivariate analysis showed that AO fracture type and reduction quality were independent risk factors for outcome.

CONCLUSION

Dual buttress plates technique provided a favourable quality of fracture reduction and satisfactory clinical function. Appropriate selection for operation chance, limited soft tissue stripping and filling of osseous defects may lessen or prevent serious complications. Fracture reduction quality and AO fracture type were independent risk factors for clinical function.