Trial reportEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025
Uniaxial versus polyaxial plating in tibial plateau fractures: a pilot prospective randomized controlled trial.
Trial report in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
5 authors.
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Abstract
purposePolyaxial plates allow screw placement at variable angles, offering potential advantages over monoaxial locking plates. However, no comparative studies have assessed their efficacy in tibial plateau fractures. This study evaluates the clinical, radiological, and functional outcomes of uniaxial versus polyaxial locking plates in tibial plateau fracture management.
methodsThis prospective randomized controlled trial included 40 patients with AO/OTA 41 B-C tibial plateau fractures. Patients were stratified into low-grade (Schatzker 1-3) and high-grade (Schatzker 4-6) fractures and randomized to receive either uniaxial or polyaxial locking plates. Clinical (Visual Analogue Scale and Rasmussen clinical scores), radiological (Rasmussen radiological score), and functional (Knee Society functional score and Knee Injury and Osteoarthritis Outcome score) assessments were conducted at 3, 6, 12, and 24 months postoperatively.
resultsThe study included 32 high-grade and eight low-grade fractures, predominantly in young males (M:F = 37:3). Both groups had comparable demographics and fracture patterns. The polyaxial plating group (n = 20) had reduced intra-operative radiation exposure. However, no significant differences were observed in overall clinical, radiological, and functional outcomes (p > 0.05). Subgroup analysis of high-grade fractures showed significantly better clinical scores in the polyaxial group beyond six months up to the last follow up (p < 0.05).
conclusionsPolyaxial plates facilitate fixation and reduce intra-operative variables. While radiological and functional outcomes were similar, clinical outcomes were slightly better in high-grade fractures. These findings suggest polyaxial plates could be preferable for managing complex tibial plateau fractures. LEVEL OF EVIDENCE: Therapeutic Level 1.
trial registrationCTRI/2020/02/023280, https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MzgyMzk=&Enc=&userName=. Registered on: 13/02/2020.
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