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

Abstract

BACKGROUND The knee joint is one of the major weightbearing joints in the lower extremity. Generally, these injuries fall into two broad categories, high energy fractures and low energy fractures. Fractures of the proximal tibia are the result of high energy injuries and because of 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. MATERIALSANDMETHODS The study was conducted between the period of October 2013 to August 2015 in Vijayanagara Institute of Medical Sciences, Ballari. 26 patients with diagnosis of proximal tibial fractures were treated with locking compression plate. All Schatzker's classification type 1-6 proximal tibial fractures in adults aged 18 years and above of either sex were included in the study. All patients were followed up. With each follow up, clinical and radiological examinations were performed at 6 weeks, 3 months and 6 months. RESULTS The study included26 patients, 25 males and 1 female aged from 21-80 years with mean age of 41.03 years. The average time for fracture union in our series was 16.61 weeks. In present study, knee stiffness was observed in 2 patients. Our study yielded excellent to good results in 80% of 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 ofmotion. For minimally-displaced fractures with minimal bone defects percutaneous fixation suffices, whereas for comminuted fractures, open reduction and internal fixation is mandatory. In our study, we found that proximal tibial locking plate provides complete union and early mobilisation to attain better functional outcome.