Functional and Radiological Outcomes of Proximal Tibia Fracture Treated With Dual Tibial Plating: A Retrospective...

Proximal tibial fractures, particularly bicondylar variants (AO/OTA 41-C), are complex injuries usually resulting from high-energy trauma. These fractures are characterized by articular comminution and metaphyseal instability. Dual tibial plating provides superior biomechanical stability by stabilizing both columns, which reduces the risk of varus collapse and facilitates early mobilization compared to isolated lateral plating.

This retrospective observational study included 50 skeletally mature patients (≥18 years) with closed or Gustilo-Anderson type I or II proximal tibial fractures treated with dual tibial plating at a tertiary care center between July 2022 and June 2025. Patients with type III open fractures, pathological fractures, polytrauma affecting rehabilitation, or incomplete records were excluded. Clinical outcomes were assessed using the visual analog scale (VAS) for pain and knee range of motion (ROM). Radiological union was evaluated using the radiographic union score for tibial fractures (RUST) at 1, 3, and 6 months. Statistical analysis was performed using IBM Corp. Released 2020. IBM SPSS Statistics for Windows, Version 26. Armonk, NY: IBM Corp., with p < 0.05 considered statistically significant.

All 50 patients completed a minimum follow-up period of six months. Clinical union was achieved in all cases. Radiological union was confirmed in 48 patients (96%) at the final follow-up, while delayed union occurred in two patients (4%). Superficial infection was observed in four patients (8%), with no cases of deep infection reported. Significant improvements in VAS pain scores and knee range of motion were observed during serial follow-ups (p < 0.001).

Dual tibial plating offers stable and reliable fixation for complex proximal tibial fractures, leading to high union rates, favorable functional recovery, and an acceptable complication profile. Therefore, it is an effective treatment option for appropriately selected patients.