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Comparison of the results of the synthesis of Schatzker II and III tibial plateau fractures by screwing versus plate

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Abstract

Purpose

Lateral tibial plateau fractures with depression are the most common. Their treatment is currently surgical. Many therapeutic procedures have been described.

Our aim is to evaluate the results of open surgery and to compare the two internal fixation methods used: lag screw versus plates.

Materials and methods

This is a retrospective comparative study of two series of tibial plateau fractures Schatzker types II and III treated surgically over a period of ten years with two different methods:

Group A: Internal fixation using screws for 86 patients.

Group B: Internal fixation using plates for 71 patients.

Functional and anatomical results were assessed according to Rasmussen’s clinical and radiological scores.

Results

The patients’ average age was 44 years (range from 18 to 76). The male gender was predominant (104 males and 53 females).

Road traffic accidents were the most common aetiology with over two thirds of the cases. The fractures were type Schatzker II in 61% of the cases. The mean follow-up was five years.

Although the clinical and radiological Rasmussen scores were better in group A (internal fixation with lag screws), those differences were statistically insignificant (p = 0.6 and p = 0.8). Group A clinical and radiological scores were 26.06 and 16.57, respectively and those of group B were 25.72 and 16.45.

We noticed more sepsis and skin complications and a longer operating time (95 min versus 70 min) in group B patients with a statistically significant difference.

None of the patients of our series had bone grafting.

Conclusion

For Schatzker II and III fractures, an internal fixation with lag screws would be preferable when possible especially in the case of a pure depression fracture. It yields satisfactory results with a shorter operating time and less complication rate.

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Data Availability

Raw data were generated at Mohamed Taher Maamouri hospital, Nabeul, Tunisia. Derived data supporting the finding of this study are available from the corresponding author (M.Jlidi) on request.

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Funding

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests.

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Authors and Affiliations

  1. Orthopedics and Traumatology Department, Mohamed Taher Maamouri Hospital, AFH City, 8050, Mrezgua, Nabeul, Tunisia

    Jlidi Mohamed, Walid Bouaicha, Mouldi Lamouchi, Ahmed Ben Ammar & Selim Daas

  2. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia

    Jlidi Mohamed, Walid Bouaicha, Salma Jaziri & Selim Daas

  3. Department of Anaesthesia and Intensive Care, Mohamed Bourguiba Hospital, Kef, Tunisia

    Salma Jaziri

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  1. Jlidi Mohamed
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All the authors participated in the design, performance, analysis and drafting of this manuscript.

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Correspondence to Jlidi Mohamed.

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Mohamed, J., Bouaicha, W., Lamouchi, M. et al. Comparison of the results of the synthesis of Schatzker II and III tibial plateau fractures by screwing versus plate. International Orthopaedics (SICOT) 47, 2073–2083 (2023). https://doi.org/10.1007/s00264-023-05849-z

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