Conservative verses percutaneous screw fixation for tibial plateau fracture

Objective: To evaluate the results of conservative verses percutaneous screw fixation for tibial plateau fracture. Methodology: This randomized control trial was conducted at Private medical centres of Peshawar, Pakistan from March 2014 to December 2017. Patients of tibial plateau fracture were allocated to group A and group B with lottery method. In group A, the screws were used where as group B was managed conservatively with plaster of Paris. Following discharge, all patients were advised follow up at 2 weeks, 1month, 3 months, 6 months and 12 months. Efficacy of either procedure was assessed by comparing the knee society score. Results: Out of 48 patients, 37 were males and 11 females. Mean age in both groups was 29.87+5.73 years. Common cause of injury was road traffic injury (56.25%) followed by history of fall (25%). Time taken for union was 12.3 weeks in group A and 14.1 weeks in group B. Screw loosening was significant complication in group A (P=0.018) while ankle stiffness and delayed union were significant complications in group B (P=0.037 and 0.018, respectively). Hospital stay was significantly longer in group A (P=0.0389). There was no significant difference in range of motion in both groups (P=0.179). Conclusion: Screw fixation was better option for Schatzker type I fractures than plaster of paris with fewer complications.