EVALUATION OF TREATMENT SCHATZKER TYPE-I TIBIAL PLATEAU FRACTURE WITH PERCUTANEOUS CANNULATED CANCELLOUS SCREW FIXATION

Muhammad Rafiqul Islam*, Md. Shah Alam, Ripan Gosh, Rashedul Islam and Jibonanondo Halder

ABSTRACT

Background: Tibial plateau fractures, intra-articular in nature and caused by high-velocity trauma, constitute approximately 1% of all fractures. Primary goal in the management of proximal tibial articular fracture to be a stable, congruous, pain-free, mobile joint. Objective: To find out the result of fixation of Sehatzker type-I tibial plateau fracture with percutaneous cancellous cannulated screw. Methods: The present prospective observational study of management of Schatzker type-I tibial plateau fracture with percutaneous screw fixation was carried out during the period from May 2019 to June 2020 at the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka. Out of 40 initially selected patients, 7 patients did not report for follow-up. Therefore, the result of the study was based on 33 patients. All the 33 cases were Schatzker type-I tibial plateau fracture. Results: The age of the patients ranged from 20 to 53 years, mean (±SD) being 38.45±1.55 years. 24(72.72%) were male and 9(27.28%) were female. Road traffic accident 21(63.6%), domestic accident 5(15.2%) and fall from height 7(21.2%). Right side was affected more, i.e. 20(60.6%). At the final follow-up, all cases were evaluated clinically and radiologically. Plateau tilting was found in 2 case (6.1%), valgus tilt in 2 case (6.1%), condylar widening in 7 (21.2%) cases, articular step-off in 8 (24.2%) cases and >50% joint space narrowing in 1 case (3.0%). Less than 50 percent joint space narrowing was found in 7(21.2%) cases. Results were graded using Rasmussen's criteria. The overall results were satisfactory in 30 (90.9%) and unsatisfactory in 3(9.1%). Conclusion: Considering outcome of treatment, it can be concluded that percutaneous screw fixation in Schatzker type-1 tibial plateau fracture is a satisfactory method of treatment.

Keywords: Tibial plateau, Percutaneous cancellous, Cannulated screw.