Functional and radiological outcome of schatzker type II, III, VI fractures treated via subchondral RAFT system combined with locking compression plate

Abstract

Need for the study: Treatment of proximal tibia fracture is difficult especially when intraarticular and metaphyseal comminution present. The tibial plateau involves weight bearing so restoration of joint congruity is important to preserve normal function of knee. Subchondral raft construction is one popular method under investigation for this purpose where subchondral screws support the bone pieces along with cartilage and prevent it to depress again. Aim: to evaluate clinical and radiological results of Schatzker type II, III, VI fractures treated using open reduction and internal fixation with subchondral RAFT system combined with lateral plateau locking compression plates. Methods: 30 patients of proximal tibial plateau split fracture and depression, including men and women aged >18 years who came to department of orthopaedics GMCH between 2017 to 2019 were enrolled in the study. Diagnosis made by x-rays and computerized tomography. In all patients, the depressed joint line was elevated and fixed with subchondral RAFT screws through the locking compression plate. At the last follow up, clinical and radiological data were recorded. Results: The mean ROM was 110.5 0 (range 90 0 -125 0 ), Mean KSS was 90.2 (range 65-100), Mean Rasmussen radio score was 15.6(range 10-18). All 30 patients showed signs of fracture healing on follow up x-rays and on final follow up complete bone union. Two patients developed superficial infection and one patient had screw backout on 2 nd follow up. none encountered major intra or post-operative complications. Conclusion: Subchondral RAFT combined with locking compression plate helps surgeon to maintain the anatomical reduction of depressed intraarticular fragment with satisfactory functional and radiological outcome.