Prospective analysis of functional outcome of bicondylar tibial plateau fractures treated by fixation with locking compression plates
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2016, Vol 20, Issue 1
Abstract
Introduction: High energy tibial plateau fractures (Schatzker type V, VI) are associated with severe soft tissue injury and this complicates the treatment of this injuries. Surgical approach depends upon the site of soft tissue injury and timing of surgery depends upon the degree of soft tissue injury. The optimal treatment of Schatzker type V, VItibial plateau fractures remains controversial and challenging due to highly demanding surgical procedure and perioperative complications. In our study we have primarily used lateral locking compression plating in the treatment of bicondylartibial plateau fractures. Materials and Methods: Our study was a prospective study, conducted at the Department of Orthopaedics, Government Mohan Kumaramangalam Medical College and Hospital, Salem between May 2012 and August 2015.Anteroposterior and lateral views of x ray films were taken and 3D-CT scans were taken routinely to assess three dimensional fracture geometry. Functional assessment was done using Knee Society Score. Radiological assessment was performed taking into account two parameters: Medial proximaltibial angle and Articular step off. Results: We studied 27 patients with proximal tibial fracture who were treated with locking compression plate. Majority of cases were Schatzker type VI (85.18 %) compared to type V.In our series > 90 % cases fixed by MIPPO technique to avoid soft tissue damage and enhance the biological bone healing.In our series we have done primary bone grafting for 5 cases only. Most of our cases well united without bone grafting. In our cases majority of cases (> 80%) united between 12-16 weeks (average 13.7 weeks). In our study the clinical outcome of most of the patients (19) was excellent, which was based upon Knee society score. 06 patients had good and two patients with fair results. Conclusion: Early mobilization is possible with LCP because of absolute stability given by the implant and this contributes to better knee range of motion. Medial condyle coronal fracture and small posteromedial fragment should be buttressed by posteromedial plating. Not all bicondylar fractures are same, treatment should be precise to individual fracture pattern. Bicondylartibial plateau fractures treated with locking compression plate have an excellent to good functional outcome with very minimal wound complications.
Authors and Affiliations
M Kannan
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