Vol. 7, Issue 1, Part B (2025)

Background: Tibial plateau fractures are high-energy articular injuries demanding anatomical reduction and stable fixation for optimal outcomes. Dual plating has gained importance in bicondylar fractures, providing superior stability and alignment compared with single lateral plating. However, controversies persist regarding single versus dual plating and incision strategies.
Objective: To evaluate clinical and radiological outcomes of dual plating in Schatzker type V and VI fractures and to analyze the surgical indications, approaches, and comparative results with single plating.
Materials and Methods: Thirty patients with bicondylar tibial plateau fractures (Schatzker V-VI) underwent dual plating after soft-tissue optimization. Follow-up assessments were conducted at 6 weeks, 3 and 6 months post-surgery. Clinical outcomes were evaluated using the Oxford Knee Score (OKS), while radiological assessments utilized standard imaging techniques to monitor fracture healing. Complications and technical details regarding incision approaches were also analyzed.
Results: The mean age was 42.8 years, with 24 males. Twelve (40%) had excellent OKS, 10 (33.3%) good, 6 (20%) fair, and 1 (3.3%) poor at six months. Radiological union occurred in 27 (90%) at 14 weeks. Complication rate was 16.7%.
Conclusion: Dual plating offers superior biomechanical stability and reliable union in types V-VI fractures. Two-incision approaches help preserve soft tissue integrity in complex bicondylar or medial column fractures. Single incisions may suffice in select low-energy or noncomminuted patterns. Future studies with larger cohorts and extended follow-up are essential to validate these results and establish long-term efficacy.