Management of Tibial Plateau Fractures Using Joshi’s External Stabilizing System
Journal Title: Journal of Bone and Joint Diseases - Year 2018, Vol 0, Issue 0
Abstract
Background: Tibial plateau is one of the most critical weight-bearing joints in the lower limb. Fractures involving the tibial plateau can jeopardize the knee motion, stability, and extremity alignment. The goal of treating tibial plateau fractures include restoration of the articular surface, preservation of mobility, joint stability and soft tissue envelop envelope, freedom from pain as well the alignment of the lower limb with the long-term goal being prevention of post-traumatic arthritis of the knee joint. The current study was done to review the functional outcomes of closed reduction and fixation of tibial plateau with Joshi’s external stabilizing system (JESS). Material and Methods: Between December 2015 and December 2017, this prospective study comprised 25 cases of tibial plateau fractures. All 25 cases were managed by closed reduction and external fixation using JESS. Routine radiographs of the knee including the leg in the anteroposterior and lateral views were done. Computed tomography scan of the knee joint was prescribed as routine to know the pattern of fracture. In all the cases, 6.5 mm cannulated cancellous screw was placed in the juxta-articular bone to achieve the intrafragmentary compression to support the cancellous bone fragments. Fracture of the tibial plateau was classified according the Schatzker’s classification. Patients were followed up for an average of 12 months. Functional outcomes were assessed by modified Rasmussen functional scoring. Result: Of the 25 patients, 16 (64.0%) males and 9 (36.0%) females. The most common mode of injury was road traffic accident. Of the tibial plateau fractures, 8 cases were of Schatzker type 6; this was the most common fracture pattern noted in our study. The most common complication was pin tract infection (n = 6). No nonunion was observed. There were 96% showed excellent results and 4% showed good results after 12 months follow-up. Conclusions: JESS is an excellent and minimally invasive method for the management of proximal tibial fractures. It not only obviates the need of open reduction and internal fixation and/or plaster of Paris cast but also gives excellent functional results. In compound fractures, JESS prevents excessive tissue handling, wound dehiscence, and post-operative surgical site infection.
Authors and Affiliations
Kapil Kumar, Najmul Huda, Ajay Pant
Keywords
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