EVALUATION AND MANAGEMENT OF COMPLEX TIBIAL PLATEAU FRACTURE WITH POSTERIOR ARTICULAR INVOLVEMENT USING A NOVEL CONCEPT OF "THREE-COLUMN FIXATION"

Abstract

OBJECTIVE

To evaluate the outcome of the management of complex tibial plateau fracture with posterior articular involvement using a novel concept 'three-column fixation.

STUDY DESIGN

Prospective cohort study

METHODOLOGY

A total 45 patients aged 18–60 years with posterior tibial plateau fractures were enrolled using consecutive sampling. All underwent three-column fixation. Radiological reduction, fracture union, knee range of motion, and Oxford Knee Score were assessed. Data were analysed using descriptive statistics and appropriate inferential tests, with significance set at p ≤ 0.05.

RESULTS

The mean age was 39.2 ± 13.4 years; 25 (55.6%) were female. Mean MPTA and PTPA were 86.8 ±

2.9° and 10.5 ± 2.8°, respectively. Satisfactory fracture reduction was achieved in 18 (40.0%) patients, and fracture union in 24 (53.3%). Mean knee range of motion was 116.7 ± 12.9°, with a mean Oxford Knee Score of 33.2 ± 5.4. Left-sided injuries showed significantly better functional outcomes (p=0.027).

CONCLUSION

Three-column fixation demonstrated satisfactory radiological and clinical outcomes in patients with complex tibial plateau fractures involving the posterior column. The technique allowed restoration of alignment, fracture stability, and knee function in a substantial proportion of cases. Clinical outcome showed a significant association with the side of injury, while patient age, gender, and injury mechanism were not significantly related to postoperative functional recovery.