Management of Bicondylar Fractures of Proximal Tibia with Ender's Nail and Proximal Lateral Tibial Plate

Bicondylar fractures of the proximal tibia (Schatzker type V and VI) are challenging due to articular involvement and soft-tissue compromise. Conventional fixation risks malalignment, delayed rehabilitation, and soft-tissue complications. This study evaluated the clinical, radiological, and functional outcomes of Schatzker type V and VI fractures managed with a combination of Ender's nails and a proximal lateral tibial plate, providing a minimally invasive yet stable construct.

Thirty patients underwent fixation with Ender's nails and a lateral tibial plate. Follow-up included clinical and radiological assessments at 6 weeks, 3 months, and 6 months. Functional outcomes were measured using the Rasmussen scoring system.

The cohort (26 males and 4 females) had a mean age of 42.9 years. Functional assessment showed mean pain and walking scores of 4.45 ± 0.61 and 4.05 ± 0.61, respectively, with an overall score of 21.65 ± 2.96. Radiological evaluation showed mean scores of 2.30 ± 0.57 for articular depression, 1.90 ± 0.31 for condylar widening, 2.00 ± 0.00 for alignment, and 0.56 ± 0.00 for osteoarthrosis (total 6.70 ± 1.26). Functional outcomes were excellent in 13.3%, good in 53.3%, and fair in 33.3%; radiological outcomes were excellent in 10%, good in 46.7%, fair in 40%, and poor in 3.3%.

Hybrid fixation with Ender's nails and a lateral tibial plate provides stable management of Schatzker type V and VI fractures, with satisfactory radiological union, good functional recovery, and minimal soft-tissue complications. It is a viable alternative to dual plating.