A Study to Know Short Term Outcome of Tricolumnar Plating in Complex Tibial Plateau Fractures

Volume 8 | Issue 2   | Aug – Sep 2020 | Page: 2-6 | S. B Kamareddy, Pradeep Kumar Natikar, Mujtaba Hussain Patel

Authors: S. B Kamareddy [1], Pradeep Kumar Natikar [2], Mujtaba Hussain Patel [1,2]

[1] Kamareddy Ortho and Trauma Care Centre, Kalaburagi, Gulbarga, Karnataka, India.
[2] Department of Orthopaedics, KBNIMS Kalaburagi, Gulbarga, Karnataka, India.

Address of Correspondence
Dr. Pradeep Kumar Natikar,
KBNIMS Kalaburagi, Gulbarga, Karnataka, India.
E-mail: drpradeepnatikar@gmail.com


Background: Tricolumnar plate fixation in comminuted proximal tibial fractures remains a new concept to have a rigid construct and to improve the functional outcome with dual incision. We performed a retrospective study to evaluate the functional outcome of proximal tibial fracture fixation using tricolumn plating.
Objective: The objective of the study was to study the clinical outcome of internal fixation with tricolumnar plating for the treatment of complex tibial plateau fractures.
Materials and Methods: The study was conducted in tertiary care center, Kalaburagi, over a period of 2 years from June 2017 to June 2019. Twenty patients with complex tibial plateau fractures were treated with tricolumnar plating through posteromedial and anterolateral approaches. There were 12 males and 8 females, with an average age of 45.2 years old (ranged, 32–60 years old). Fourteen patients had injuries in the left side and 6 patients had injuries in the right side. According to Schatzker classification, 14 patients were type V and 6 patients were type VI.
According to the three-column classification, all the patients had injuries of lateral, medial, and posterior columns. All the patients were evaluated using the Oxford Knee Score at 6-month and 1-year follow-up.
Results: The mean interval from injury to operation was 9.4 days (ranged, 6–15 days). The bone union time ranged from 4 to 10 months after operation. According to the results of Oxford Knee Score, 14 patients got an excellent result, 3 good, and 3 moderate.
Conclusion: Tricolumnar plate fixation for the treatment of complex tibial plateau fractures is effective to achieve anatomic reduction, rigid internal fixation, and good functional outcome. Careful soft-tissue handling and employing minimally invasive techniques minimize soft-tissue complications.
Key words: Tricolumnar plating, Schatzker classification, Oxford Knee Score.


1. Luo CF, Sun H, Zhang B, Zeng BF (2010) Three-column fixation for complex tibial plateau fractures. J Orthop Trauma 24(11):683–692. doi:10.1097/BOT.0b013e3181d436f3
2. Krieg JC. Proximal tibial fracture: current treatment, results, and problems. Injury. 2003;34:A2–A10.
3. Ricci WM, Rudzki JR, Borrelli J. Treatment of complex proximal tibia fractures with the less invasive skeletal stabilization system. J OrthopTrauma. 2004;18:521–527.
4. Carlson DA. Posterior bicondylar tibial plateau fractures. J Orthop Trauma. 2005;19:73–78.
5. Barei DP, Nork SE, Mills WJ, Complications associated with internal fixation of high-energy bicondylar tibial plateau fractures utilizing a two incision technique. J Orthop Trauma. 2004;18:649–657
6. Weil YA, Gardner MJ, Boraiah SB, Posteromedial supine approach for reduction and fixation of medial and bicondylar tibial plateau fractures. J Orthop Trauma. 2008;22: 357–62.
7. Barei DP, O’Mara TJ, Taitsman LA, Frequency and fracture morphology of the posteromedial fragment in bicondylar tibial plateau fracture patterns. J Orthop Trauma. 2008;22:176–82.
8. Luo CF, Jiang R, Hu CF, Medial double-plating for fracture dislocations involving the proximal tibia. Knee. 2006;13:389–94
9. Hackl W, Riedl J, Reichkendler M, Preoperative computerized tomography diagnosis of fractures of the tibial plateau. Unfallchirurg.2001;104:519–523
10. Wicky S, Blaser PF, Blanc CH, et al. Comparison between standardradiography and spiral CT with 3D reconstruction in the evaluation,classification and management of tibial plateau fractures. Eur Radiol.2000;10:1227–1232
11. Schatzker J, Tile M. The Rationale of Operative Fracture Care, 2nd ed.Berlin: Springer-Verlag; 1996:390–391.
12. Macarini L, Murrone M, Marini S, et al. Tibial plateau fractures:evaluation with multidetector-CT. Radiol Med. 2004;108:503–514.
13. Bhattacharyya T, McCarty LP 3rd, Harris MB, et al. The posterior shearing tibial plateau fracture: treatment and results via a posterior approach. J Orthop Trauma. 2005;19: 305–310.
14. Eggli et al. Unstable Bicondylar Tibial Plateau Fractures: A Clinical Investigation. J Orthop Trauma. 2008; 22: 673-679.
15. Su EP, Westrich GH, Rana AJ, Kapoor K, Helfet DL. Operative treatment of tibial plateau fractures in patients older than 55years. Clin Orthop Relat Res 2004;421: 240‑8
16. Barei DP, Nork SE, Mills WJ, Coles CP, Henley MB, BenirschkeSK. Functional outcomes of severe bicondylar tibial plateau fractures treated with dual incisions and medial and lateral plates. J Bone Joint Surg Am 2006;88: 1713‑21
17. Pelsar PM. Controversies in the management of tibial plateau fractures. SA Orthopaedic Journal. 2010, 75.
18. Zhang Y. Treatment of Complicated Tibial Plateau fractures with Dual Plating via 2 incision technique, Orthosupersite.com. 2012; 35:3.

How to Cite this article: Kamareddy SB, Natikar PK, Patel MH | A Study to Know Short Term Outcome of Tricolumnar Plating in Complex Tibial Plateau Fractures | Journal of Karnataka Orthopaedic Association | August-September 2020; 8(2): 2-6.

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