Comparison of outcome of unilateral locking plate and dual plating in the treatment of bicondylar XXXX .

@entity1 @entity308 @entity174 @entity2850 @entity893
BACKGROUND: @entity174 ( @entity174 ) includes different @entity174 patterns with varied degrees of articular @entity308 and displacement. Many kinds of fixators, including newly designed plate with locking screws, were applied to treat these complicated fractures. We intended to follow up the surgical outcomes of (1) unilateral locking plate, (2) classic dual plates, or (3) hybrid dual plates for @entity174 . MATERIALS AND METHODS: We retrospectively reviewed 76 @entity1 with @entity174 , Schatzker types V and VI, who we operated from June 2006 to May 2009 in our institute. Excluding @entity1 who expired due to other medical conditions and without complete follow-up, 45 @entity1 were sorted out in this series. The scheme of surgical intervention was designed by visiting staff, and 15 @entity1 , as group I, were treated with unilateral locking plate. The other 19 @entity1 , as group II, were treated with classic dual plates. The residual 11 @entity1 , as group III, were treated with hybrid dual plates (one lateral approach @entity2850 ( @entity2850 )   +   medial anti-gliding plate). All @entity1 were under periodic F/U at about 6  weeks interval for at least 18  months postoperatively. RESULTS: In group I, 13 cases achieved solid bony union without obvious traumatic OA change, limitation of ROM, or @entity893 . In groups II and III, 15 and 10 @entity1 reached the same goal, respectively. By analysis of the recorded parameters with statistical software (SPSS 12.0), there were five parameters with significant difference, including Schatzker classification, operation time, staged treatment or not, hospitalization period, and hardware impingement. CONCLUSIONS: There was no significant statistical difference of union rate between these three groups in our series. Based on our clinical follow-up, several key points were emphasized: (1) Soft tissue problems should be kept in mind, and usage of locking plate can reduce the discomfort of hardware impingement effectively. (2) The single lateral approach technique for @entity174 with locking plate results in less operation time and shorter hospitalization period. (3) If the medial buttress cannot be established by reduction of the lateral @entity174 , then open reduction of the medial side is necessary and buttresses the medial fragment by dual plates.
