Meta-analysis shows that highly comminuted bicondylar tibial plateau fractures treated by single lateral locking plate give similar outcomes as dual plate fixation.

OBJECTIVES: This meta-analysis was conducted to compare the clinical outcomes of single lateral locking plate (SP) versus dual plate fixation (DP) for the repair of bicondylar tibial plateau fractures (AO/OTA type C or Schatzker type V and VI).

METHODS: PubMed, Embase, Medline, CNKI, Wanfang database and Chinese VIP information were searched to identify the randomized and prospective comparative clinical studies which concern the treatment of bicondylar tibial plateau fractures (AO/OTA type C or Schatzker type V and VI) both with SP and DP fixation before October 1, 2015. STATA version 11.0 (Stata Corporation, College Station, TX, USA) was used for data-analysis after the critical assessment of the methodological quality of the trials.

RESULTS: Finally, nine trials comprising 559 patients were included for this meta-analysis after the filtration. There were no significant differences between SP fixation and DP fixation with regards to outcomes for bone graft, post-operative malalignment and post-operative malreduciton in surgical details; infection, venous thrombosis, implant irritation and loss of reduction in complications; knee motion range in final outcomes. Lower surgical time, hospital stay, union time and incision necrosis were found in SP fixation compared with DP fixation. High rate of loss of alignment and more satisfaction with 12-month HSS score were associated with SP fixation than with DP fixation.

CONCLUSIONS: Both SP fixation and DP fixation are acceptable strategies for managing this type of fracture. However, more high quality RCTs with large number of patients and long-term clinical evaluations are required to determine the optimal strategy for bicondylar tibial plateau fractures.