Original Articles
Assessment of functional outcome of locking plate osteosynthesis in proximal tibia fracture | |
Dr. Nishant Narayan Gholap, Dr. Sunkara Mangala Bhargav, Dr. Amar Vishal | |
Background: Fractures in the upper portion of the tibia, the largest bone in the lower leg, are referred to as proximal tibial fractures. Due to complex anatomy of the proximal tibia and the nature of soft tissue covering present around it, there is still a dilemma regarding surgical treatment of proximaltibia fractures. Conservative management of displaced proximal tibia fractures, there is high rate of knee stiffness, non-union, malunion, mechanical failure and late varus collapse, and functional disability reported by many studies. Treatment by conventional available plates (T plate L plate) the results are not promising. Elizarov technique/hybrid external fixator, Less Invasive Stabilisation System (LISS) is ideal but it is expensive and cumbersome for the patient and rate of pin tract infection and mechanical malalignment is high as reported by some studies. Hence, we have decided to study the anatomically pre contoured lockingcompressive plates (LCP) and here we are giving our results of 70 patients operated with LCP This study provides findings regarding duration of fracture healing, the union rate, and to study various complications and to compare with other studies reported earlier. The present study was conducted to assess the functional outcome of locking compressive plate osteosynthesis (ORIF & MIPPO) in proximal tibia fractures. Materials & Methods:70 proximal tibial fractures of both genders admitted on day-to-day basis in the casualty at our hospital during February 2020 to October 2023 and were treated with MIPPO and ORIF with LCP. Parameters such asgender, age, side, nature of injury, type of fracture, type of reduction, principal, approach to fix it and whether monocolumnar, bicolumnar or Tri columnar fixation done, duration of fracture union, and functional outcome according to Knee Society Score (KSS) and complications etc. were recorded. Results: Out of70 patients, males were 38 and females 32. The type of fracture was vertical split 29, split with depression 16, only depression 4, medial condyle fracture in 9, bicondylar fracture in8, and bicondylar with metaphysio diaphyseal extension in 4 patients. Side was left in28 and right in42 cases. The method of reduction was ORIF in26 and MIPPO in 44 cases. The principle of reduction was compression in40, bridging in22, and combined in8 cases. The difference was significant (P< 0.05). Common complications were knee instability in 1, knee joint stiffness in3, superficial infection in2, and varus deformity in 1 case. The difference was significant (P< 0.05). We have got27.14 %( 19cases) excellent, 62.85 %( 44cases) good, 7.14 %( 5cases) satisfactory, 2.85% (2 cases) poor result which is comparable with other methods of treatment Conclusion: For the treatment of proximal tibia fractures, the use of locking compression plates in combination with open reduction and internal fixation (ORIF) and MIPPO is preferable for optimum functional result and less complications. |
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