Study of surgical management of tibial plateau fractures using locking compression plate

Abstract

Introduction: Knee is a major weight bearing joint of the lower limb consequently any fractures involving the proximal tibia will definitely compromise the knee function and stability. They account for only for 1% of all fractures and 8% of fractures in the elderly1.Fractures of proximal tibia have always been difficult to treat because of the subcutaneous location of its anteromedial surface. These days significant attention has been paid to the condition of soft tissue envelope. With the advent of newer implants and minimally invasive techniques, complex tibial plateau fractures which were once considered difficult to treat, are now having successful outcomes. Aim: The aim of the present study is to evaluate the results of Surgical Management of tibial plateau Fractures with Locking Compression Plate. Methods: A prospective study was done on thirty patients of proximal tibial fractures treated by locking compression plate in Orthopaedic Department of Mediciti institute of medical sciences, Medchal. Duration of study was from October 2017 to March 2019. We included patients of both the genders from 18 to 70 years of age, those were treated with locking compression plates for intra-articular and extraarticular fractures of proximal tibia. However, type II and Type III open fractures (Gustilo Anderson), pathological fractures and patients with severe comorbidities were excluded from the study. Ethics committee approval was obtained. Informed written consent was taken. Data was collected from the patients. Results: Majority of the patients with Tibial plateau fractures i.e., 8 patients (40%) were in the age group of 30-39 years. The youngest patient was 19 years and oldest patient was 58 years. Mean age in this study was 34 years. Road traffic accident was the cause for this fracture in most of the patients. All our patients were operated under spinal anesthesia with LCP for Tibial plateau fractures. MIPPO approach was used in 14 patients and open reduction was done in 6 patients. 14 patients (70%) were placed a single plate and 6 patients (30%) were done dual plating. In 1patient (5%) delayed union occurred.15 patients (75%) had excellent functional outcome, good functional outcome in 3 patients (15%) and fair functional outcome in 2 (10%) patient. Conclusion:From this study, we concluded Tibial plateau LCP system is an exciting new method of osteosynthesis for complex tibial plateau fractures allowing early mobilization and good functional outcome with limited number of complications.