Das Nikhilesh, Mishra Suman S, Mohanty Anuraag, Sahoo Dhananjay
Department of Orthopaedics, Peerless Hospital and B.K. Roy Research Centre, Kolkata, IND.
Department of Orthopaedics, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Cureus. 2025 Apr 29;17(4):e83167. doi: 10.7759/cureus.83167. eCollection 2025 Apr.
Aim The research aimed to assess the functional and radiological results of posterior plate fixation in complex types of posterior tibial plateau fractures (PTPFs) with special regard to the stability of the region, healing of the fractures, and the patient's functioning several years after surgery. Materials and methods An exhaustive study of the concerned group of patients was done on 30 individuals who underwent posterior plate fixation for closed PTPFs at the Department of Orthopaedics and Traumatology, Peerless Hospital and B.K. Roy Research Centre, Kolkata, India, from September 2018 to March 2021. A thorough clinical and radiological follow-up was carried out for every patient at set periods of time, before and after the operation. After a thorough study, key outcome metrics were measured, such as duration of fracture union, articular congruity, Knee Society Scores (KSS), International Knee Documentation Committee (IKDC) scores, range of motion (ROM) of the knee, and complications. Results The study included 30 participants, with a mean age of 40.70 ± 8.46 years. These included 25 males and 5 females. All fractures showed radiological union after a mean of 16.2 ± 3.1 weeks. Excellent articular congruity (≤2 mm step-off) was achieved in 29 (96.6%) cases. The mean clinical and functional KSS was 85.60 ± 7.09 and 81.23 ± 6.09, respectively; the mean IKDC score was 70.83 ± 6.92. Mean knee flexion achieved was 122.60° ± 8.08°, and all patients achieved independent ambulation at a mean of 18.1 ± 2.6 weeks. Complications managed conservatively included superficial infection in three (10%) patients and knee stiffness in four (13.3%) patients. Conclusion Posterior plate fixation has proven to be simple and effective, achieving excellent radiological and functional outcomes. Patients were able to gain early movement and independent walking by the final follow-up, with all patients having stable fixation. The technique was reliable, with low complication rates and no implant failures or nonunion, and was an effective surgical treatment for complex PTPFs.
目的 本研究旨在评估后外侧钢板固定治疗复杂类型胫骨平台后外侧骨折（PTPF）的功能和影像学结果，特别关注该区域的稳定性、骨折愈合情况以及患者术后数年的功能状况。
材料与方法 对印度加尔各答Peerless医院和B.K. Roy研究中心骨科与创伤科2018年9月至2021年3月期间接受后外侧钢板固定治疗闭合性PTPF的30例患者进行了详尽研究。在手术前后的特定时间对每位患者进行了全面的临床和影像学随访。经过深入研究，测量了关键结局指标，如骨折愈合时间、关节面平整度、膝关节协会评分（KSS）、国际膝关节文献委员会（IKDC）评分、膝关节活动范围（ROM）以及并发症情况。
结果 该研究纳入30例参与者，平均年龄为40.70±8.46岁。其中男性25例，女性5例。所有骨折平均在16.2±3.1周后达到影像学愈合。29例（96.6%）患者实现了良好的关节面平整度（台阶差≤2mm）。临床和功能KSS评分的平均值分别为85.60±7.09和81.23±6.09；IKDC评分的平均值为70.83±6.92。膝关节平均屈曲角度达到122.60°±8.08°，所有患者平均在18.1±2.6周时实现独立行走。保守处理的并发症包括3例（10%）患者发生浅表感染，4例（13.3%）患者出现膝关节僵硬。
结论 后外侧钢板固定已被证明简单有效，可实现优异的影像学和功能结果。到最终随访时，患者能够早期活动并独立行走，所有患者的固定均稳定。该技术可靠，并发症发生率低，无植入物失败或骨不连情况，是治疗复杂PTPF有效的手术方法。
