1Department of Orthopaedics, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam-603103, Chennai, Tamil Nadu, India. Emails: rocksayan13@gmail.com; arun5684@gmail.com; dr_prad87@yahoo.co.in; jatoosaquib@gmail.com; shivaanivenkat@hotmail.com; stevemerw@gmail.com
*Corresponding Email: arun5684@gmail.com
*Co-corresponding Email: dr_prad87@yahoo.co.in
Received: 12th Dec, 2025; Revised: 12th Feb 2026; Accepted: 13th Feb, 2026; Available Online: 10th March, 2026
Background: The primary aim of surgical treatment in tibial plateau fractures is to restore joint congruity, limb alignment, and stability. Bicolumnar fixation achieves this by addressing each condyle separately and ensuring stable fixation across the entire proximal tibial surface. Unlike single lateral plating, which leaves the medial column vulnerable to collapse, dual plating provides equal support and distributes forces evenly, reducing the risk of secondary displacement. Biomechanical studies have consistently demonstrated that dual plating offers greater construct stability than single plating. In a cadaveric study, dual plating significantly improved resistance to axial and rotational forces, particularly when the medial plateau was comminuted or fragmented. These findings were corroborated by clinical data showing fewer mechanical failures and improved knee function in dual plating groups. Another rationale for bicolumnar fixation is the anatomic reduction it allows. The use of two separate incisions (anterolateral and posteromedial) provides direct access to fracture fragments, enabling accurate reduction under vision. This is particularly useful in fractures with posteromedial shear, which may not be adequately addressed via a lateral-only approach. Dual plating also facilitates earlier weight-bearing in most cases. The rigid fixation allows physiotherapists to begin range-of-motion exercises earlier, reducing the risk of stiffness. In properly selected patients, this approach supports better quadriceps recovery, quicker return to ambulation, and higher patient satisfaction scores. Though concerns about increased soft tissue complications have been raised, several recent studies suggest that with proper technique and soft tissue handling, infection rates and wound dehiscence can be kept low. Dual plating is not only biomechanically superior but also functionally advantageous, justifying its growing acceptance as the standard of care in bicondylar tibial plateau fracture.
Methods: This prospective study involved 35 patients with schatzker's type 5 and 6 proximal tibia fractures. Each fracture fixed with bicolumnar plating. Functional outcomes were assessed using Knee Society Score, Medial Proximal Tibial Angle, Articular Step-off, Verbal Pain Scale, Knee range of motion, Time to radiological union and Complications like as infection, stiffness, loss of reduction, hardware-related issues.
Results: In summary, this section presented a comprehensive analysis of clinical, radiological, and functional outcomes in 35 patients with complex tibial plateau fractures (Schatzker Type V and VI), majority of patients were male (60%), with a mean age of 39.6 years, and the most common cause of injury was road traffic accidents (RTAs) managed surgically with bicolumnar plating. The section was structured to sequentially address demographic patterns, improvements in functional status using Knee Society Score which showed statistically significant improvement from a mean of 78.00 at 2 weeks to 92.14 at 6 months (p < 0.001), radiographic alignment parameters (MPTA and step-off), range of motion, bone healing patterns and complication profiles. Inferential statistics were also employed to identify predictors of poor outcomes.
Conclusion: The findings strongly support the effectiveness of bicolumnar plating for managing high-grade tibial plateau fractures. The approach provided stable fixation, good alignment, minimal complications, and allowed early mobilization, resulting in favorable functional and radiological outcomes in most patients.
Keywords: Proximal Tibia Fracture, Schatzkar type fracture, Bicolumnar plating of proximal tibia, Knee society score, Medial proximal tibia angle, Tibial plateau fracture, Tibial articular step off, Knee range of motion, Verbal pain scale, Dual plating of Tibia.
How to cite this article: Khan S, Arun Kumar K V, Elangovan P, Jatoo SA, Venkatramanan S, Merwyn S. Assessment of Functional Outcome of Bicolumnar Plating Done for Schatzker Type 5 and 6 Proximal Tibia Fracture. Int J Drug Deliv Technol. 2026;16(3): 599-610. DOI: 10.25258/ijddt.16.3.67
Source of support: Nil.
Conflict of interest: None