Senthil Kumar, K (2010) A case study of periarticular fractures of the tibia managed with biological plate fixation. 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..Of these fracture of proximal and distal tibia have historically been difficult to treat Because of 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 in to 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, concept of early surgical fixation and Early post operative mobilization of joint all have convincingly improved the functional out come of the patient to a large extent. Spanning external fixator are associated pin tract infection, vascular problem, and difficulty in maintain the articular alignment and lags interfragmentary compression Hybrid fixators are associated with less stable fixation, nonunion, pintract infection vascular injury. Biological plate fixation techniques. are based upon the principles of limited soft tissue stripping, maintenance of the osteogenic fracture hematoma, and preservation of vascular supply to the individual fracture fragments while restoring axial and rotational alignment, and providing sufficient stability to allow progression of motion, uncomplicated fracture healing, and eventual return to function. As such, the evolution of biological plating techniques has led to the development of low-profile, precontoured implants specifically intended for application in the proximal and distal tibia. AIM: 1. To discuss the management of periarticular fractures of tibia. 2. To evaluate the advantage of biological plate fixation. 3. To evaluate the functional and radiological,clinical outcome after biological plate fixation. MATERIALS AND METHODS: The period of surgery and follow up extends from November 2007 to November 2009. It includes periarticular fracture of proximal and distal tibia Pathological fracture, compound grade 3 fracture, paediatric fracture were excluded There are 11 cases include in this study The case were analyzed as per the following criteria; 1 Age distribution, 2 Sex distribution, 3 Mode of injury, 4 Anatomy of injury, 5 Time of union. RESULTS: In our study we included 12patient 6 of them were proximal tibia fracture and 6 of them were distal tibia fracture 3were female 9 were male , mode of injury is road traffic accident we did surgery by 6th day to allow the edema to subside to give time for soft tissue damage two patient in proximal tibia and two pt in distal tibia had excellent results One pt developed skin necrosis later flap cover done since we immobilize the pt in POP three patient developed stiffness but later the had increased rang e of movements One patent developed infection which was controlled with higher spectrum antibiotic after pus culture sensitivity one pt had delayed union where we did a cancellous bone grafting as second stage procedure all pt showed union of fracture on an average of 5 month. CONCLUSION: To summarize the advantage of biological fixation are Minimally invasive procedure, Less skin and soft tisuue demanding, Preservation of fracture hematoma, Increased callus formation, Less incidence of infection, Increase union rate, Less incidence of neurovascular injury. Disadvantage are Surgical expertise, Increased cost, C- arm availability.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | periarticular fractures ; tibia management ; biological plate fixation ; case study. |
| Subjects: | MEDICAL > Orthopaedics |
| Depositing User: | Subramani R |
| Date Deposited: | 16 Sep 2017 15:50 |
| Last Modified: | 17 Sep 2017 06:25 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/2946 |
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