CLOSED TIBIAL PLATEAU FRACTURES;

Comparative study of conservative (pop cast) versus percutaneous screw fixation for the treatment

Abstract

Objective: The aims & objectives of the study are to compare the results of tibial
plateau fracture treated by plaster of paris cast and percutaneous screw fixation. Study design:
Comparative study. Place and duration of study: Study was carried out at the Orthopaedics
Unit-II, Liaquat University Hospital Hyderabad / Jamshoro , from January February 2010 to
october 2011. Methodology: Between February 2010 to october 2011, 31 men and 9 women
aged 20 to 40 years with means 28.25 years underwent plaster of paris and percutaneous screw
fixation for schatzkar type I closed tibial plataue fracture in Orthopaedics Unit-II, Liaquat
University Hospital Hyderabad / Jamshoro. Data was analyzed through SPSS software version
16.0. Results: In both groups 31(77.5%) men and 9(22.5%) women with male: female ratio of
3.4:1 and aged 20 to 40 years with means 28.25 years. Union time range 10 to 24 weeks in both
groups(p value 0.001). The mean healing time in PSF group was 11.6 weeks while in POP group
it was 13.9 weeks. The complications seen in this study were pain during walking (5 (25%)
patients in POP VS 3 (15%) patients in PSF group), knee stiffness (4(20%) patients in POP VS 2
(20%) patients in PSF group ), ankle stiffness (3(15%) patients in POP VS 1(5%) patients in PSF
group), delay union (2(10%) patients in POP VS 1(5%) patients in PSF group ), non union (2(10%)
patients in POP VS 0(0%) patients in PSF group ) P value 0.040. The longer duration of hospital
stay about -10-20 days in 13(65%) of POP patients as compared to PSF cases where majority
16(80%) were discharged within 1 to 10 days( p value 0.148). The patients with complications had
still longer stay in both group. The mean hospital stay in POP group was 14.6 days and PSF group
was 8.4 days. The clinical results seen in this study were excellent (5(25%) patients in POP VS
13(65%) patients in PSF group), good (8(40%) patients in POP VS 5(25%) patients in PSF group),
fair (5 (25%) patients in POP VS 2 (10%) patients in PSF group ) and poor (2(10%) patients in POP
VS 0 (00%) patients in PSF group. Conclusions: We conclude that percutaneous screw fixation
gives better results in type I schatzkartibial plateau fracture compared to plaster of paris cast. The
complications were seen higher in POP cast.