Assessing Functional Outcomes in the Management of Tibial Plateau Fractures

Abstract

BACKGROUND

 Despite extensive research and documentation, there remains a contentious debate regarding the optimal treatment approach for tibial plateau fractures, namely surgical versus conservative methods. While some surgeons advocate for non-surgical options, suggesting that many cases can be effectively managed without surgery, others argue that conservative approaches may lack efficacy and advocate for surgical intervention in the majority of cases to achieve precise alignment and stable internal fixation. This study aims to elucidate the fundamental principles of managing tibial plateau fractures, with a particular emphasis on utilizing rigid fixation, and to present innovative clinical findings comparing outcomes between surgical and conservative strategies.

MATERIALS AND METHODS

This prospective cohort study was conducted at the Department of Orthopedics at Saveetha Medical College and Hospital in Thandalam from June 1, 2022, to June 31, 2023. All patients received treatment according to a standardized protocol. Of the 40 patients enrolled, 20 underwent surgical intervention while the remaining 20 received conservative management. Regular follow-up assessments were performed, including monthly check X-rays and evaluations of range of motion, angular deformity, and patient-reported complaints.

 RESULTS

 The study comprised 40 patients diagnosed with tibial plateau fractures, divided into two groups: 20 patients managed conservatively with skin traction and pop slab application, and 20 patients treated surgically with open reduction internal fixation using plate osteosynthesis. Of these patients, 17 were female and 23 were male, with right-sided injuries being more prevalent in 22 cases. Type-2 fractures were the most common, followed by type-1 fractures. Infections occurred in 6 patients treated conservatively and in 2 patients treated surgically. However, these infections were effectively addressed through appropriate antibiotic therapy and regular wound care.

 CONCLUSIONS

 In our study, we conclude that surgical management of proximal tibial fractures provides excellent functional outcomes compared to conservative management. Surgical intervention allows for early mobilization of patients with fewer complications and shorter hospital stays.