Comparison of Dual Plating versus Single Lateral Plating in Bicondylar Proximal Tibial Fractures

Open Access

Abstract

Background: Bicondylar proximal tibial fractures are complex injuries often caused by high-energy trauma, posing challenges in achieving stable fixation and good functional outcomes. Evidence comparing dual plating and single lateral plating remains inconclusive, especially in South Asian populations, highlighting the need for further study. Objective: The aim of the study was to compare the clinical, radiological, and functional outcomes of dual plating versus single lateral plating in patients with bicondylar proximal tibial fractures. Methods & Materials: This prospective comparative study at the Department of Orthopaedic & Traumatology, Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh (July–December 2025) included 50 patients with bicondylar proximal tibial fractures (Schatzker V–VI) to compare dual versus single lateral plating. Patients were evaluated preoperatively, underwent standard fixation, and followed for radiological, functional, and complication outcomes. Data were analyzed using SPSS with p < 0.05 considered significant. Results: In 50 patients (25 dual, 25 single lateral plating), baseline characteristics were comparable. Dual plating had longer operative time (112 ± 15 vs 85 ± 12 min), higher blood loss (310 ± 60 vs 220 ± 50 mL), and longer hospital stay (8.4 ± 2.1 vs 6.2 ± 1.8 days; all p < 0.001). Radiological outcomes, functional scores, knee ROM, and complications were similar between groups, indicating comparable healing and safety despite greater surgical demands with dual plating. Conclusion: Both dual plating and single lateral plating provide satisfactory outcomes for bicondylar proximal tibial fractures, with dual plating offering slightly better stability but increased surgical demands.