Tibia fractures, by its location and by being subcutaneous in most of its length tend to be open very commonly. Due to its precarious blood supply and scanty soft tissue coverage orthopaedic surgeons around the world have been fighting infections and union problems associated with its fractures. Our aim of this study focuses on the outcome of locking plates used in metaphyseal fractures of tibia in terms of union, complications and functional outcome of patients. An Observational prospective study of 30 patients with close or open grade I fractures of proximal tibia (Metaphyseal) without intra-articular extension, with recent (<4 weeks) history of trauma was carried out at Department of Orthopaedics, Medical college and SSG Hospital, Vadodara, Gujarat from Jan 2018 to June 2018. During the follow up, all patients achieved full weight bearing at 20-24 weeks. Twenty four (83.33%) patients could squat or sit cross legged without difficulty. Five (16.66%) patients had slight difficulty doing the same. According to Rasmussen's score, in our study we had 43.33% patients (13) with excellent, 40% patients (12) with good and 16.66% patients (5) with fair clinical results. We had 80% patients (24) with excellent and 20% patients (6) with good radiological results. Extra-articular proximal tibia fractures can be treated successfully through MIPPO technique with fewer and less serious complications, marginally faster union time and superior clinical outcome.

Infection is a major problem in orthopaedics quite often leading to implant failure. The aim of the study is to determine the outcome of infection after internal fixation of fractures and the risk for non-union in infected fractures. We evaluated 34 patients with 34 fractures that were infected after internal fixation to be followed up in this study from August 2017 to December 2018. At final follow up the surveillance showed satisfactory results in 31 (91.2%) cases and the rest 03 (8.8%) had an unfavourable outcome in terms of Non Union and persistent infection. Of the 34 patients enrolled in the study, 22 had sound bony union at the time of presentation. Of the 12 fractures which had not progressed to union, 9 eventually united. Only 3 patients showed no clinical or radiological signs of union at the end of the study. Of the 3 patients who did not achieve union by the end of the study only 1 continued to be infected. Infection persisted in 2 patients in spite of achieving good union. Statistical analysis showed association of the surgery-infection interval and the type of microorganism identified. Late infections had a higher chance of failure in culture. Infection when intervened and adequately treated does not quite appear to interfere with the process of union.