A Clinical Study Of Proximal Tibial Fractures Treated With Locking Compression Plate

Abstract

Knee joint is one of the major weight bearing joints in the lower extremity. The proximal tibial fractures are one of the commonest intra-articular fractures. Generally these injuries fall into two broad categories, high energy fractures and low energy fractures. Fractures of the proximal tibia are the results of high-energy injuries, and because of the lack of soft tissue coverage in this region. The majority of tibial plateau fractures are secondary to high speed velocity accidents and fall from height. Fractures result from direct axial compression, usually with a valgus or varus moment and indirect shear forces. The aim of surgical treatment of proximal tibia fracture is to restore congruent articular surfaces of the tibial condyles maintaining the mechanical axis and restoring ligamentous stability eventually can achieve functional painless and good range of motion in the knee joint. OBJECTIVE:  The objective is to study the functional outcome and duration of union in proximal tibial fractures treated with locking compression plate. METHODS: The study was conducted between the period of october 2013 to august 2015 in Shri. B.M. Patil medical college, hospital and research centre, VIJAYAPUR. 26 patients with diagnosis of proximal tibial fractures were treated with locking compression plate. All Schatzker’s classification type 1 to 6 proximal tibial fractures in adults aged 18 years and above of either sex were included in the study. All xii patients were followed up. With each follow up, clinical and radiological examinations were performed at 6 weeks, 3months and 6months. RESULTS: The study included 26 patients, 25 male and 1 female aged from 21 to 80 years with mean age of 41.03 years. The average time for fracture union in our series was 16.61 weeks. In the present study, knee stiffness was observed in 2 patients. Our study yielded excellent to good results in 80% of the cases. CONCLUSION: Displaced tibial plateau fractures are best managed operatively. Optimal knee function is achieved by accurate anatomical reduction and secure fixation followed by early mobilisation to attain functional arc of motion. For minimally displaced fractures with minimal bone defects percutaneous fixation suffices where as for more comminuted fractures open reduction and internal fixation is mandatory. Post operative rehabilitation protocol in terms of non-weight bearing and achieving satisfactory range of motion needs to be strictly adhered to, in order to obtain optimal functional results. In our study we found that proximal tibial locking plate provides complete union and early mobilisation to attain better functional outcome.