Functional Outcomes of Posteromedial Condylar Tibial Plateau Fractures Using Locking Compression Plates

Open Access

Abstract

Background: Posteromedial condylar tibial plateau fractures are challenging intra-articular injuries that compromise knee stability and joint congruity. These fractures, often resulting from high-energy trauma, are biomechanically significant but frequently underdiagnosed or inadequately addressed, leading to suboptimal outcomes. Locking compression plates (LCPs) have emerged as a promising fixation method, offering angular stability and improved outcomes in complex fracture patterns. Aim of the study: To assess the functional and radiological outcomes of posteromedial tibial plateau fractures treated with locking compression plates and to identify factors influencing recovery. Methods & Materials: This prospective observational study included 55 adult patients with isolated posteromedial tibial plateau fractures treated at a tertiary care center. All patients underwent surgical fixation using the posteromedial approach with anatomically contoured LCPs. Functional outcomes were assessed using the Lysholm Knee Scoring Scale and the Knee injury and Osteoarthritis Outcome Score (KOOS) at final follow-up. Radiological union, weight-bearing milestones, and complications were also recorded. Statistical analyses included t-tests, Pearson correlation, and multivariate linear regression. Data analysis was conducted using SPSS version26. Result: The majority of patients showed favorable recovery, with good to excellent functional scores and a mean Lysholm score of 86.3±8.4. KOOS subscale scores also reflected high patient satisfaction and restored function. Younger age, Schatzker type IV fractures, shorter time to surgery, and earlier radiological union were significantly associated with better functional outcomes (p < 0.05). The complication rate was low, with minimal cases of infection, malunion, or implant failure. Conclusion: Locking compression plate fixation offers a reliable and biomechanically stable solution for posteromedial tibial plateau fractures, particularly when combined with early surgical intervention and targeted rehabilitation. The findings support its use as a preferred method in managing these complex injuries. Larger, multicenter trials are recommended to further validate these outcomes.