Functional outcome following treatment of distal tibia fractures using locking compression plate

Abstract

Aims and ObjectivesTo Study functional outcome, efficacy and safety of distal tibia fracture by locking compression plate fixation. Methods: This was a prospective study consists of 25 consecutive cases of distal end tibia both intrarticular and extraarticular fracture selected after applying inclusion and exclusion criteria operated with LCP fixation at Sanjay Gandhi institute of trauma and Orthopaedics from June 2015 to June 2017. Functional outcome was assessed using American orthopedic foot and ankle society score (AOFAS) and visual analogue scale (VAS) at 3, 6 and 12 months postoperatively. Results: At 12 months, the mean AOFAS was 84.24. Five patients (20%) had score more then 90 (excellent), 11(44%) had score between 81-90 (good), 8(32%) had score between 71-80(fair) and 1(4%) had score less then 70 (poor). Mean AOFAS score improved from 71.36 (at 3 month) to 79.96 (at 6 month) and 84.24 (at 1 year). Mean VAS score at the end of 1 year followup was 22.4.VAS score was calculated after activity of daily life (i.e. walking on level ground) 18(72%) patients had mild pain. 4(16 %) had no pain and 3 (12%) had moderate pain after activity. No patient had severe pain. 17(68 %) cases in the study had fracture union without any complications. 8 (32 %) cases had postoperative complications ranging from superficial wound infection to delayed union and secondary arthrosis. Conclusion: Distal tibia fractures are challenging injuries not only because ankle joint has very low thresh hold for anatomic and bio mechanical aberrations but also due to huge importance of soft tissue in its healing. A constant balance has to be maintained to get antomical reduction with minimal soft tissue handling. In a closed fracture of distal end tibia, low profile LCP using MIPPO technique is currently best option for such a fracture.