A Case study of Periarticular Fractures of the Tibia Managed with Hybrid External Fixator Application

Sai Prasad, P (2009) A Case study of Periarticular Fractures of the Tibia Managed with Hybrid External Fixator Application. Masters thesis, Madurai Medical College, Madurai.

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Abstract

INTRODUCTION: Increased incidence of Road Traffic Accidents, natural disasters, industrial accidents claim most of human mortality and morbidity. Hence, it forms the major epidemic of Modern Era. Of these, fractures of Proximal and distal tibia have historically been difficult to treat. In this modern era of increasing life expectancy, there is a rise of old age population which, increases the incidence of these fractures in osteoporotic bones, adding to the morbidity. Because of the proximity of these fractures to the knee and ankle joint, regaining full knee and ankle motion and function may be difficult. Soft tissue damage, comminution, fracture extension into the knee or ankle joint lead to unsatisfactory results in many cases regardless of the treatment modality. Better understanding of the injury patterns, availability of better implants, the concept of early surgical fixation and early postoperative mobilization of joint all have convincingly improved the functional outcome of the patient to a large extent. AIM: 1. To discuss the management of periarticular fractures of tibia. 2. To evaluate the biomechanical and biological advantages of hybrid fixators. 3. To evaluate clinical, functional and radiological outcome afterhybrid fixator application. MATERIALS AND METHODS: The period of surgery and follow up extends from November 2006 to November 2008. It includes all grades of proximal and distal tibia fractures. Pathological fractures and fractures in children were excluded. The cases were analyzed as per the following criteria. 1. Age distribution, 2. Sex distribution, 3. Side of injury, 4. Mode of injury, 5. Anatomy of injury, 6. Associated injuries, 7. Open fractures, 8. Duration for surgery, 9. Time of union. The age groups varied from 21 years to 51 years with the mean age of 36.5 years. Incidence of fracture was observed maximum between 30- 40 years of age. Among the 18 cases, males were predominant with female to male ratio being 1:19. Right side was common in our series. Commonest mode of injury has been road traffic accident. RESULTS: Total 18 patients are included in the study. One case went for septicemia and went for amputation. Other patients are evaluated and studied for functional outcome. Normal bone union – 15, Delayed union – 2, Shortening – 2, Joint stiffness – 2, Varus angulation – 2, Pin tract infection – 4, Deep infection – 2. CONCLUSION: Hybrid External Fixator is very effective and useful treatment modality for periarticular fractures of tibia. It aids in providing good skin Care and it is easy for application of flap covers which is difficult in case of ilizarov circular fixators. It also acts as a definitive fixation aiding in good fracture union thereby avoiding multiple surgeries in compound fractures. Hybrid External fixator is a modular, safe and useful treatment option for complex periarticular fractures of tibia. It is minimally invasive with least complications compared to other methods which are used for peri articular fractures of tibia.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Periarticular Fractures ; Tibia Managed ; Hybrid External Fixator Application ; Case study.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 16 Sep 2017 15:37
Last Modified: 17 Sep 2017 06:05
URI: http://repository-tnmgrmu.ac.in/id/eprint/2943

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