Single long midline incision versus two small incision techniques in treatment of Schatzker type V and type VI tibial plateau fractures--a comparative study.

Tibial plateau fractures had been treated with single long midline incision technique traditionally. But recently two-incision technique is becoming popular Tibial plateau fractures are generally classified according to the method developed by Schatzker. Schatzker types V and VI fractures are high-energy fractures often accompanied by other injuries and complications, such as postoperative inflammation, wound problems and infections. It was a prospective randomised study where 56 patients with Schatzker types V and VI were included in the study group. Alternatively all were allocated in the two groups ie, two small incision and one midline incision. Two incision was better than single midline incision in terms of posteromedial collapse, postoperative infection, skin necrosis. Operative fixation of complex fractures of the tibial plateau remains quite difficult and is associated with postoperative functional limitations in a large percentage of patients. Dual plating through an anterolateral and posteromedial approach is recommended in fractures complicated by a significantly displaced posteromedial fragment or depression of the medial articular surface.