Types of depression in intraarticular tibial condylar fractures and modes of elevation: A retrospective series of 950 cases

Abstract

Background: Tibial condylar fractures are often associated with depression of articular surface and commonly used classifications describe various fracture patterns. However, these classifications do not address the types of depression of articular fragments, so we tried to classify various types of depressions of articular surface associated with tibial condylar fractures and developed a treatment algorithm based on our study, with an aim to facilitate step-wise approach for classifying and modes of elevation of depressed fragments. Material and Methods: This was an intervention study of 950 tibial condylar fractures operated at our center by single surgeon between March 2002-2016. These patients were retrospectively evaluated for radiographic and functional outcomes. Results:The study revealed mean post op condylar tilt of 5.38 ±3.55, (0-12), condylar widening of 2.68 ±1.25 (0-6mm), articular step 2.98±1.86 (0-8mm), valgus tilt 6.64±3, (0-13) and mean knee society score of 84.39±6.3, (60-98) at follow-up of 12 months post-op. All the cases were followed up for at least 24 months, mean follow-up time 87.39  35. 97 months (7.25+2.91 years).The average radiographic bony union time was 17.07 ±1.4, (14-22wks) weeks, the average full weight bearing time was 15.04 ±2, (12-24) weeks. The average range of motion of the affected knees at 12 months was 127. 6±4.46, (120-135). Conclusion: Based on our study of the various types of depression of articular surface in tibial condylar fractures, we were able to classify depression, facilitate steps of surgery and improving outcomes.