Comparison Between Conventional and Variable-Angle Locking Compression Plates in Complex Proximal Tibia Fractures

Area of Science:

• Orthopedic surgery
• Traumatology
• Biomedical engineering

Background:

• Proximal tibial fractures, especially tibial plateau injuries, necessitate precise management to restore knee function and prevent long-term disability.
• Variable-angle locking compression plates (VALCP) offer improved screw placement compared to fixed-angle plates, potentially enhancing fixation and outcomes.
• Schatzker's classification is used to categorize tibial plateau fractures, guiding treatment strategies.

Purpose of the Study:

• To compare the clinical, functional, and radiological outcomes of conventional locking compression plates (CLCP) versus VALCP for Schatzker's type I, II, and III tibial plateau fractures.
• To evaluate the efficacy of VALCP in improving fixation, enabling early mobilization, and achieving favorable patient outcomes.

Main Methods:

• A prospective study involving 60 patients with Schatzker's type I-III tibial plateau fractures, randomly assigned to CLCP or VALCP groups (30 patients each).
• Outcomes assessed using the Oxford Knee Score (OKS) and Rasmussen's functional and radiological grading systems at six-month follow-up.
• Surgical duration, fixation stability, and postoperative complications were monitored.

Main Results:

• VALCP group showed slightly higher rates of excellent functional (60% vs 50%), radiological (80% vs 73.33%), and OKS (86.67% vs 73.33%) outcomes at six months.
• Road traffic accidents were the primary cause of injury, particularly in the VALCP group (86.67%).
• Complications were minimal in both groups, with 90% of VALCP patients experiencing none.

Conclusions:

• VALCP appears to be a viable treatment for tibial plateau fractures, potentially improving fixation and facilitating early mobilization.
• While VALCP demonstrated slightly better outcomes, the differences between VALCP and CLCP were not statistically significant in this study.
• Limitations include a small sample size, short follow-up period, and fracture heterogeneity.