A Study on Clinical, Functional and Radiological outcome of High Velocity Tibial Plateau fractures managed by dual plating

Manoj Kumar, R (2016) A Study on Clinical, Functional and Radiological outcome of High Velocity Tibial Plateau fractures managed by dual plating. Masters thesis, Kilpauk Medical College, Chennai.

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Abstract

BACKGROUND: Dual plating in comminuted bi-condylar tibial plateau fractures remains controversial. More methods of treatment have been described, each has got its own merits and demerits. We performed a prospective study to evaluate the Clinical , functional and Radiological outcome of lateral and medial plate fixation of Schatzker type V and VI fractures through an anterolateral approach, and a posteromedial approach. MATERIAL AND METHOD: We treated 21 high velocity tibial plateau fractures ( Schatzker type V and VI ) with lateral and medial plates through an anterolateral approach and a posteromedial approach over 2 years period . Radiographs in two planes were taken in all cases. Immediate postoperative radiographs were assessed for quality of reduction and fixation. The outcome was evaluated according to the Honkonen Jarvinen criteria on follow up. RESULTS: The incidence of male was more compared to females in the ratio - 3.2 : 1. The nature of injury is high velocity injury as it is explained by all patient sustaining road traffic accident .None had sustained injury as a result of trivial trauma as occurs in elderly with osteoporotic bone.The incidence of fracture in right side was 42.9 % and in left side was 57.1 % which nearly equal.Among 21 cases, the incidence of fracture in age group 40 -50 was 52.4 %.Of 21 fractures , 7 patients ( 33.3 % ) had Type V fracture and 14 patients ( 66.7 %) had Type VI fracture.There were no associated injury in all patients .All patients underwent standard surgical procedure by anterolateral & posteromedial approach .Lateral locking plates were used for lateral plateau and T/L Buttress, Semi tubular, Recon plates were used for medial plateau.Bone Grafting was used for 9 patients ( 42.9%) to fill metaphy seal defect.Time required for union ranged from 11 to 16 weeks with average being 12.9 weeks. CONCLUSION: High velocity tibial plateau fracture have excellent to good clinical, functional and radiological outcome . Early mobilisation of the joint provides good range of motion . Posteromedial plating provides a buttress to posteromedial fragment and thereby prevents varus collapse.The patients with good soft tissue cover should undergo anatomical reduction and rigid fixation immediately without deferring time. This is a short term study and need follow up to predict the further outcome.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Functional ; Clinical ; Radiological ; High Velocity ; Tibial Plateau fractures ; Dual plating.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 16 Sep 2017 19:34
Last Modified: 16 Sep 2017 19:34
URI: http://repository-tnmgrmu.ac.in/id/eprint/3197

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