Volume 15 | Issue 3 | July-September 2020 | Page 16-19 | Shailendra R. Patil, Ajay A. Nayakawadi
Authers: Shailendra R. Patil [1], Ajay A.Nayakawadi [1]
[1] 1Department of Orthopaedics, ACPM Medical College, Dhule
Address of Correspondence
Dr. Ajay A. Nayakawadi,
Department of Orthopaedics, ACPM Medical College, Dhule
E-mail: ajaynayakawadi@gmail.com
Abstract
Background and Objectives: Incidence of fracture of the proximal tibia is increasing regularly due to road traffic accident. Because of the involvement of the knee joint, restoration of articular congruity and stability is of prime importance to achieve this surgical treatment is best option. There are various implants used for surgery like percutaneous cancellous screw, conventional buttress plate, locking compression plate. The new generation locking plates developed over regular buttress plates for better outcome. So our aim is to study functional outcome, range of movements of the knee, duration for union and complications using locking compression plate in the proximal tibial fractures.
Methods: We studied 50 patients involving proximal tibial fracture in prospective manner. Among them 48 patients operated with ORIF and 2 patients with MIPPO technique.
Results: All patients were followed up till complete union of the fracture. Average follow up period was 16 to 24 weeks. Those patients in whom fracture was fixed in a biological manner using minimal invasive technique results in early union compared to patients treated by open reduction techniques.
We used IKDC score (International knee documentation committee) for the evaluation of clinical results. We had total 3 complications include 2 knee joint stiffness and 1 varus deformity at 6 month follow up. There were no cases of implant failure or implant related complication in our study.
Conclusion: The patient sample approximately reflected the regular trauma patients encountered at our setup, fracture treated with bridge plating and combined principle of conventional and internal fixation (bridge plating) healed rapidly by secondary fracture union and hence achieving strong union across the fracture at a much earlier time compared to LCP as conventional plate. The MIPPO type of reduction and fixation was less time consuming, less soft tissue injury so preserve the bone blood supply subsequently helps in healing of both soft tissue and bone faster.
Keywords: Locking compression plate; interal fixator; bridge plating; MIPO.
References
1. Schulak DJ,Gunn DR. Fracture of the tibial plateau.Clinic orthop 1975 June109;166-177.
2. Koval KJ,Hulful DL.Tibial plateau fracture : evaluation and treatment J Am Acad orthop surg 1995;3(2):86-94
3. Wagner M. General principles for the clinical use of the LCP. Injury 2003 Nov;34, Suppl 2: B31-42.
4. Whittle AP, Wood II GW. Fracture of lower extremity. Chapter 51. In : Campbell operative orthopedics. Canale ST ed. 10th edn, Vol. 3. New York, Mosby; 2003. p. 2782-2796.
5. Sommer C, Gautier E, Muller M. For clinical application of the LCP. Injury 2003 Nov; 34, Suppl 2:B43-54
6. Stoffel K, Dietaru. Biomechanical testing of the LCP how can stability in locked internal fixator be controlled. Injury 2003 Nov;34, Suppl 2:B11-9.
7. Cong-Feng L. Tibia, proximal. In: Buckley RE, Moran CG,Apivatthakakul T (Eds). AO principles of fracture management. 3rd ed.New York: Theime: 2017. p877-97.
| How to Cite this article: Patil SR, Nayakawadi AA. Treatment of proximal tibia fractures with locking compression plate: a prospective study. Journal of Trauma and Orthopaedic Surgery Jul-Sep 2020;15(3): 16-19. |