Keywords:
Proximal tibia fractures, locking compression plate, minimally invasive percutaneous plate osteosynthesis, Intra-articular fractures
Abstract
Introduction: Ever since the advents of high velocity transport system, there is an alarming increase in road traffic accident (RTA) with increased orthopaedic related morbidity and mortality. Proximal tibia being involved in body weight transmission through knee joint and leg, it plays a vital role in knee function and stability. The aim of surgical treatment of proximal tibial fractures is to restore and preserve normal knee function, which can be accomplished by anatomical restoration of articular surfaces, maintaining mechanical axis, restoring ligamentous stability and preserving a functional pain free range of motion of knee. Treatment of these injuries using minimally invasive percutaneous plate osteosynthesis (MIPPO) techniques may minimize soft tissue injuries and damage to vascular integrity of fracture fragments.
Materials and Methods: This study was a hospital based prospective study centered in department of orthopedics at R.L. Jalappa Hospital and Research Centre attached to Sri Devaraj Urs Medical College, Kolar, from December 2013 to May 2015 in which 30 patients with proximal tibia fractures were treated with locking compression plate (LCP).
Results: The assessment of clinical outcome was made according to Rasmussens functional grading system. End results showed excellent outcome in 26 cases and good outcome in 4 cases. On subjective evaluation, 4 patients had superficial wound infection, 1 patient had deep vein thrombosis and 4 patients had extensor lag of 100-150 at the end of final follow-up.
Conclusion: Surgical management of proximal tibial fractures will give excellent anatomical reduction and rigid fixation to restore articular congruity, help to facilitate early mobilization and reducing post-traumatic osteoarthritis and hence to achieve optimal knee function. LCP remains a good choice in comminuted or more severe patterns of fractures.
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