Evaluation of the bilateral dual plate internal fixation technique for rotationally dislocated tibial plateau fractures

Abstract

Abstract Purpose This study aims to explore the clinical efficacy of dual plate internal fixation through a bilateral approach for the treatment of rotationally dislocated tibial plateau fractures. Methods Clinical data of 20 patients (6 male, 14 female) with rotational dislocation type tibial flat fractures treated from January 2020 to April 2022 were retrospectively analyzed. Out of all fractures, 12 occurred on the right side, and 8 on the left side. The average age of the patients was 51.9 ± 13.11 years. All patients underwent surgical treatment using the bilateral approach with dual plate internal fixation, and the related surgical indicators were recorded. After surgery, data such as fracture line disappearance time (in months), tibial plateau varus angle (TPA), tibial plateau posterior angle (PA), joint range of motion (ROM), New York Hospital for Special Surgery Hospital (HSS) knee joint function score, Rasmussen score, visual analog scale (VAS) score for pain, and Fugl–Meyer motor function assessment (FMA) score were recorded, along with the incidence of postoperative complications. Results All patients were followed up for 13.55 ± 9.75 months. The average time for the disappearance of the patients’ fracture line was 3.75 ± 0.91 months. Comparisons of TPA, PA, ROM, HSS score, Rasmussen score, and VAS score at immediately and 3 month after surgery, as well as 6 and 12 months after surgery. The research results revealed that there is a statistically significant differences (P < 0.05) between 3, 6, and 12 months after surgery and immediately after surgery. The FMA score indicated an excellent and good rate of 80% at 12 months after surgery. Postoperative complications included superficial skin infection at the incision in 2 (10.0%) cases, delayed union of fractures in 2 (10%) cases, limited mobility in 1 (5.0%) case, knee instability in 2 (10.0%) cases, and traumatic arthritis in 4 (20%) cases. Conclusion The bilateral approach involving dual plate internal fixation was used to treat rotational dislocation tibial plateau fractures. This technique has the advantages of fast intraoperative reduction, high stability of internal fixation, fewer postoperative complications, and good recovery of knee joint function, proving its potential as an effective and safe treatment method.