A comparison of lateral fixation versus dual plating for simple bicondylar fractures

• There is no consensus view on treatment of bicondylar tibial plateau fractures.
• We investigated the effect of lateral locking plate and dual buttress plates in the fixation of simple bicondylar fractures.
• We compared the clinical and radiographic results of two groups treated with dual plates and lateral locking plate.
• Lateral locking plate provided the same stability and less operation time when compared to dual plates.

BackgroundThe best fixation method for bicondylar tibial plateau fracture is debated. The aim of this study was to compare the effect of a lateral locking plate with that of dual plates in the treatment of tibial plateau fracture with a relatively intact medial condyle fragment.MethodsEighty-six patients diagnosed with a bicondylar tibial plateau fracture with a relatively intact medial condyle were assigned to groups treated with either dual buttress plates (DP group) or a lateral locking plate (LP group). Preoperative characteristics, surgical details, and postoperative complications were recorded and compared between groups. Hospital for Special Surgery Knee Scoring System score was used to evaluate clinical outcome.ResultsBoth groups displayed satisfactory clinical and radiographic results. There were no significant differences in associated preoperative conditions between the DP and LP groups. Durations of hospital stay and operation were significantly shorter, and blood loss significantly less, in the LP group than in the DP group (P = 0.045;0.038;0.031). The rate of delayed-union was significantly lower in the LP group than in the DP group (P = 0.023).ConclusionBoth dual-plate and lateral locking-plate fixation can provide satisfactory treatment of bicondylar tibial plateau fractures if properly used. When the medial tibial condyle is relatively intact, a lateral locking plate can provide stability similar to that of dual plate while decreasing operative duration and soft-tissue complications, which can assist fracture healing and shorten hospital stay.Level of evidenceI — Randomized controlled trial.