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

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. 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. 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. 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.