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title:Evaluation of Functional Outcome of Tibial Plateau Fracture Fixation Based on CT Scan Based Three Column Classification

Author:Sanjay N Modi, Keyur M Vaghela

Keywords:Tibial platue fracture, CT scan

Type:Original Article

Abstract:"Introduction: Tibia plateau fractures are a diverse group of fractures that represent a wide spectrum of severity that ranges from a single injury with predictably excellent outcomes after non operative treatment to complex fracture patterns that challenge even the most experience surgeons. Management of proximal tibia plateau fractures using CT based three column classification addresses fracture efficiently and advantageous in planning for fixation especially in bi-condylar fractures involving posterior column. Several different surgical approaches have been described for tibia plateau fractures (medial, lateral, posteromedial, posterolateral and combined) depending on the location of the fracture. This classification provides ease for selection of these approaches for particular fracture involving particular column preoperatively. Aim and objective: To access and analyze the functional, radiological and clinical outcomes of operatively managed proximal tibia plateau fractures based on their column of involvement. The study will help in identifying advantages in management of proximal tibia plateau fracture with help of CT- scan based three column classification. As this is recent advances, outcome of this study will highlights the usefulness of this classification in identification of complex fracture pattern. Method: This study was mainly a Descriptive longitudinal study. With the ethical committee clearance this study was carried out at Department of Orthopaedics, SMIMER medical college, Surat from July 2017 to November 2019, inclusive of both. A sample size of 50 (41 male, 9 female) patients was selected to evaluate fractures of Tibia plateau using CT scan based 3 column classification. Results: The functional outcome of the patients are acceptable in our study, suggesting that CT scan based 3 column classification is useful in evaluation of fracture pattern and selecting proper approach. Previously used Schatzker classification never addresses posterior column fracture which has limitation in articular understanding and planning for operation. CT scan helps in assessment of fracture pattern and also highly useful in planning for fixation and execution of procedure. Therefore, better clinical outcome is present in our study. More complex fracture like Schatzker type 5 and 6 involving posterior column had poor outcome previously using X-ray based Schatzker classification, whereas in our study threecolumn involving posterior column has good to excellent outcome. So, in present Era, Conclusion: CT scan is necessary for investigation in all tibial plateau fractures. Using CT Scan, CT based three column classification provides."

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