Role of Intraoperative Cholangiogram in Major Liver Resection and Complex Bilio-enteric Bypass Surgery

Background One of the most challenging intra-articular fractures to treat is tibial plateau fracture type V and VI because of its controversial treatment protocol. Surgical intervention is the most compatible modality to achieve stable internal fixation and early joint movements. Although the soft tissue is compromised and chance of infection is high due to long exposure time, but the outcome is good after surgery. Objective To evaluate the clinical and functional outcome treated with open reduction and internal fixation (ORIF) and factors effecting the outcome of the patients. Method We treated 52 cases of Schatzker type V and VI tibial plateau fracture from April 2018 to May 2020. All of them were managed surgically and the outcomes were evaluated with regular follow ups using oxford knee scoring (OKS) criteria. Result Forty-three cases (82.7%) had excellent Oxford Knee Scoring (OKS). Wound infections were seen in 5 cases resulting poor outcome (Mean 24.0 compared to 44.7, p = 0.007). Female patients had better outcome in comparison to male patients (Mean 45.0 compared to 41.5, p = 0.041). Older patients had poor outcomes with negative correlation of 0.371, p = 0.007. Conclusion Open Reduction and Internal fixation in Schatzker type V and VI tibial plateau fractures is an excellent treatment option to achieve good clinical and functional outcome within short period of time interval with very minimum chance of malunion and other complications improving the patients' quality of life. Age, gender and infection are some of the factors that alters the outcome.