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Column Involvement as a Predictor of Early Functional Outcome and Complications in Proximal Tibia Fractures: A
Meet Ajay Mehta1, Avik Kumar Naskar1, Saurabh Kunwar1
1Department of Orthopaedics, Indira Gandhi Government Medical College and Hospital, Nagpur, Maharashtra, India.
Introduction:
The three-column concept has enhanced understanding of proximal tibial fracture morphology and surgical planning. However, its role as a prognostic indicator remains underexplored. This study evaluates whether column involvement predicts early functional outcome and complications.
Materials And Methods:
A prospective study of 30 patients with proximal tibial fractures treated with open reduction and internal fixation was conducted. Fractures were classified into single-, two-, and three-column injuries. Functional outcomes were assessed using the Modified Rasmussen score at follow-up of 8 months. Complications were recorded. Statistical analysis was performed using analysis of variance and Chi-square tests.
Results:
Single-column fractures showed predominantly excellent outcomes, while three-column fractures had a higher proportion of fair to poor outcomes. A statistically significant association was observed between increasing column involvement and poorer functional outcome (P < 0.001). Complications were more frequent in fractures involving multiple columns, especially three-column injuries.
Conclusion:
Column involvement is a significant determinant of early outcome in proximal tibial fractures. Increasing fracture complexity predicts poorer functional results and higher complication rates, highlighting the prognostic relevance of the three-column concept.
