Background: Bicondylar tibial plateau fractures present a therapeutic challenge to the orthopaedic trauma surgeon, both in terms of the osseous injury as well as the concomitant soft-tissue insult. Double Plating with single incision or dual incisions provide more insult to the compromised soft tissue. However, single locking plate combines the technical advantages of an angular stable plate with those of the modern biological plating technique. Methods: The Study was held at Razi Orthopedic hospital in Kuwait. Between May 2012 and November 2013, 20 patients with a mean age of 37.65 years (Range from 24– 57 years) with bicondylar tibial plateau fractures with or without metaphyseal extension. Patients were diagnosed clinically, checked with standard X-rays, CT was done for all cases. Patients were treated by single lateral anatomically contoured locked plate through LISS or Polyaxial locking plate systems with or without additional screws from medial side. Radiological evaluation and functional assessment was done according to the Rasmussen Knee score. Patients were followed-up for an average of 12 months. Results: Union was achieved in all patients with a mean knee range of motion of 1.5°-130° (range: 0°-10° for extension lag, range: 100°-135° for flexion). The mean Functional Rasmussen Knee score at 6 month follow up (25.32±1.53 SD) ranged from (23.0-28.0). The mean Functional Rasmussen Knee score at last follow-up was (28.33±1.57 SD) ranged between (25.0-30.0) with significant P value (P value<0.001). The mean Anatomical Rasmussen Knee score at 6 month follow up (16.11±1.56 SD) ranged from (14.0-18.0). The mean Anatomical Rasmussen Knee score at last follow-up was (16.67±1.37 SD) ranged from (14.0-18.0) with insignificant P value (P value 0.096 ). Of the 20 patients, one patient had wound related problems, one patient had preoperative compartment syndrome, one patient suffered from hardware irritation and one patient had fixation failure upon which revision with double plating done for him. Conclusions: Surgical treatment of bicondylar tibial plateau fractures with the single lateral locked plate that was evaluated in our study can lead to a good functional and anatomical outcome and considered an effective system for providing fracture stabilization provided that the correct surgical technique is used. Awareness of potential hardware complications is essential.

Objective: In this study, we aimed to make a comparative analysis of short term clinical effectivity and side effects of intravenous zoledronate administration as single dose yearly and intravenous ibandronate administration as four doses per year. Methods: The patients whom were included in our study had osteoporosis according to WHO criteria and were treated with either parenteral zoledronate or ibandronate. 43 patients were treated with single dose of 5mg intravenous zolendronat which was applied once in a year; whereas in 39 patients were treated with 3 mg intravenous ibandronate which was applied four times in a year in three months intervals. Biochemical tests were performed in all patients before intravenous drug infusion. Side effects during drug administration and also in the first three months of the treatment were noted for all patients. Clinical effectivity was analyzed according to changes in bone mineral density (BMD) at the end of two year after treatment. Results: Eighty-two patients who were followed-up and evaluated for the effectivity and side effects of the treatment were included in our study. The compliance of patients were 100% in both groups. Mean age was 75.23±6.9 years and mean body mass index (BMI) was 26.94±7.2. In zoledronate group in which there were 23 females and 20 males. Mean age was 73.64±8.7 years and mean BMI was 27.34±4.4. In ibandronate group in which there were 39 females. There were no statistically significant differences between the groups in terms of gender (p=0.000) Mean age, BMI and rate of diagnosed side effects were not statistically significant in between the groups. According to a one-year follow-up in both groups comparison with before application had a statistically significant increase in BMD (p<0.01). However, a one-year follow-up between the two groups in terms of mean values of bone mineral density did not differ significantly (p>0.05). Conclusion: Choice of medical treatment is decided according to bone mineral density and personal risk factors in osteoporosis. Parenteral agents in the treatment of osteoporosis may be the preferred choice for the patients with comorbid diseases, using multiple drug therapies, or having trouble in using oral drug therapy. However, it should always be kept in mind that drug related side effects may be seen more commonly with parenteral agents. Clinicians should be aware of the probable side effects during and after application.