The application of a three-column internal fixation system with anatomical locking plates on comminuted fractures of the tibial plateau

Aim The purpose of this study was to describe the operative procedures and clinical outcomes of a new three-column internal fixation system with anatomical locking plates on the tibial plateau to treat complex three-column fractures of the tibial plateau. Methods From June 2011 to May 2015, 14 patients with complex three-column fractures of the tibial plateau were treated with reduction and internal fixation through an anterolateral approach combined with a posteromedial approach. The patients were randomly divided into two groups: a control group which included seven cases using common locking plates, and an experimental group which included seven cases with a new three-column internal fixation system with anatomical locking plates. Results The mean operation time of the control group was 280.7 ± 53.7 minutes, which was 215.0 ± 49.1 minutes in the experimental group. The mean intra-operative blood loss of the control group was 692.8 ± 183.5 ml, which was 471.4 ± 138.0 ml in the experimental group. The difference was statistically significant between the two groups above. The differences were not statistically significant between the following mean numbers of the two groups: Rasmussen score immediately after operation; active extension–flexion degrees of knee joint at three and 12 months post-operatively; tibial plateau varus angle (TPA) and posterior slope angle (PA) immediately after operation, at three and at 12 months post-operatively; HSS (The Hospital for Special Surgery) knee-rating score at 12 months post-operatively. All fractures healed. Conclusion A three-column internal fixation system with anatomical locking plates on tibial plateau is an effective and safe tool to treat complex three-column fractures of the tibial plateau and it is more convenient than the common plate.