European Journal of Molecular & Clinical Medicine

Abstract

Introduction: Proximal tibia fractures are one of the most common intrarticular fractures. Luo’s CT based 3 column concept helps to identify posterior column fractures which are missed on Schatzker’s plain radiograph-based classification and better understanding of fracture morphology.
Aim and Objective: To analyze the usefulness of CT based radiological assessment of tibial plateau fractures and fixation by 3 column concept.
Material and Method: This study has 25 patients with proximal tibia fractures who were enrolled in the study after due consent was taken. 3D CT scan was done in all cases along with plain x-rays. Fractures were analyzed as per Schatzker classification in addition to analysis on 3D CT. Fractures were surgically stabilized on 3 column concepts of Luo. All patients were evaluated for pain, knee ROM, walking capacity using Modified Rasmussen criteria and Visual Analogue scale. Follow up assessment of patients was done at regular interval of 6 weeks, 3 months and 6 months. The functional outcome of surgical intervention was evaluated after assessing patient’s subjective complaints, range of motion and stability of the knee joint using modified Rasmussen clinical criteria.
Result: In the present study of 25 cases, more than 65% cases were of complex Schatzker type of 4 to 6. Luo’s CT based 3 column concept helped to identify posterior column in 36% of cases. Luo classification helped better understand the pattern and morphology of fracture. The average time for union of fractures was 12.04±4.40 weeks. Fixation on basis of this concept and functional evaluation by Modified Rasmussen criteria showed the superiority of 3 column concept classification over Schatzker Classification