A comparative study based on surgical and functional outcome of proximal tibia fractures between unicondylar and bicondylar fractures

Sambit Kumar Panda, Pradyut Kumar Pradhan, Sanjay Kumar Behera, Chinmaya Debasis Panda

Abstract


Background: Tibia plateau fractures constitute 1%of all fractures. Bicondylar fractures account for 10-30%, whereas isolated medial and lateral condyle fractures constitute the remaining injuries. Although only 3% of these fractures are open injuries, many of them have closed degloving, deep abrasions or severe soft tissue injuries which require careful consideration in deciding the timing and the nature of surgery. Proximal tibia fractures may be difficult to treat even in experienced hands due to intraarticular extension, comminution, cartilage damage and soft tissue injuries of the cruciate ligaments and menisci.
Aim: To compare the functional and surgical outcomes of operative treatment of unicondylar and bicondylar fractures.
Materials and Methods: It was a prospective and comparative study of Surgical and functional outcome of proximal tibial fractures in the department of orthopaedics from July 2019 to December 2019. Clearance was obtained from the hospital ethical committee. Fifty patients were taken into consideration for the study. All patients are selected on the basis of history, clinical examination and radiography. The Schatzker’s classification was used to classify these fractures. The patients were followed up for an average period of 6 to 12 months. The patients were divided into two groups. Twenty-five patients in the unicondylar fracture group 1and 25 patients in the bicondylar fracture group 2.
Results: The mean age of group 1 patients was 45.72±10.85 years, and that of group 2 patients was 46.40±8.602 years (p>0.05). In group 1 there were 18 (72%) males and 7 (28%) females, in group 2 there were 21 (84%) males and 4 (16%) females. In group 1, the mean union time was 3.04 ± 0.351 and in
group 2 was 3.1± 0.433(p>0.05). In group 1, the mean follow-up time was 12.81 ± 2.09 and in group 2 was 13.04 ± 2.28 (p>0.05). The mean functional score of group 1 was 91.212.27, and in group 2, it was 87±18.2 (p>0.050). In group1 mean WOMAC score was 12.2 ± 21.179, and in group 2 was 16.72 ±
16.923 (p>0.05). 2 patients had hypertension, and none of the patients had diabetes. While in group two, three patients had diabetes, and two patients had hypertension.
Conclusion: In the light of the aforementioned results, it was found in the surgical and functional outcomes of both unicondylar and bicondylar fractures of the proximal tibia are satisfactory and comparable to each other. Furthermore, it was identified that Factors such as age, gender and the fracture type did not influence the outcome in both the study groups. Additionally, most fractures occurred in the middle age group with male preponderance in both unicondylar and bicondylar fractures.

Keywords: Proximal Tibia Fractures, Unicondyla fractures, Bicondylar Fractures.


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