Functional outcome analysis of column specific fixation in the management of proximal tibial fractures

Abstract

Introduction: Tibial plateau fractures commonly refer to intraarticular fractures of proximal tibia are mostly caused by high-energy injuries or even slight strike in the elderly, and the majority of patients suffering from such fractures present with soft tissue and nerve injuries, which have still not been treated properly and completely until now and can lead to poor prognosis in patients. Therefore, this condition requires a prompt interventional surgery for the sake of protecting patients’ knee joint function, which should be conducted with stringent specification as the differences in various approaches have a decisive effect on treatment efficacy [1]. Also, the traditional treatment guided by the Schatzker classification has some drawbacks in terms of precision, especially in describing posterior tibial plateau fractures in patients [2]. Studies conducted in recent years have shown that the traditional theory of fracture classification has been unable to meet clinical needs. For example, the theoretical basis of Schatzker classification is two-dimensional images, characterized by superposition, thus hardly fully demonstrating the spatial relationship of the tibial plateau and then leading to some errors. However, the theory of three-column classification, in which the tibial columns are classified into 3 parts, proposed by the scholar Congfeng Luo [1], enables orthopaedist to enrich their perceptions of disparate fracture types and then enhance the scientificity in the selection of surgical approaches, comprehensively optimizing the therapeutic effects of the surgical treatment for tibial plateau fractures [2]. As there is lack of enough evidence and research regarding this in Indian population, we propose to explore the effects of surgical treatment guided by the three-column classification method on knee joint function and postoperative complications in patients with proximal tibial fractures. Objective: To assess and analyze the functional outcome of proximal tibial fractures fixed according to 3 column classification after a follow up period of 6 months.