Effectiveness of Biological Fixation of Distal Tibial Fractures with Locking Compression Plates in Adults

Vinoth, T (2015) Effectiveness of Biological Fixation of Distal Tibial Fractures with Locking Compression Plates in Adults. Masters thesis, Thanjavur Medical College, Thanjavur.

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Abstract

AIM OF THE STUDY: To evaluate the effectiveness of biological fixation of closed distal tibial fractures in adults treated with precontoured locking compression plates designed for the distal tibia. MATERIALS AND METHODS: Cases of distal tibial fractures (closed and grade 1 open ) with /without associated fractures involving other region who presented to Department of Orthopaedics, Thanjavur Medical College,Thanjavur,during the study period, who satisfy the inclusion criteria that are studied and medically fit for surgery. STUDY DESIGN: Prospective study. SOURCE OF DATA: Patients who sustained closed and grade I open fractures of distal tibia and were treated by minimally invasive plate osteosynthesis using locking compression plate in the Department of Orthopaedics,Thanjavur Medical College,Thanjavur were taken as the study population. Sample size: 32 patients with closed and grade I open fractures of distal tibia and were treated by minimally invasive plate osteosynthesis using locking compression plate were selected for inclusion in the study. Inclusion Criteria: 1. Fresh distal tibial fractures closed and grade I open fractures. 2. Fractures of distal tibia unfavourable for interlocking nail. 3. Complex fractures of lower third of tibia. 4. Adult Patients willing to undergo surgery in both sexes. Exclusion Criteria: 1. Fractures in skeletally immature age group. 2. Significant contraindication to any anaesthesia. 3. Patient unwilling for surgery. 4. Grade II,III open fractures of distal tibia. 32 cases of adult distal tibial fractures were treated in an average period of five days with most injuries being from vehicular accidents. In spite of the bulky nature of the implant, we were able to pass the implant distal to proximally bridging the fracture under C-arm guidance. This process resulted in an acceptable reduction, though not anatomical. Except for two cases who had wound dehiscence and infection, none others came for implant removal. Excellent to good results was seen in 76.6% of the study population. This study concludes that in distal tibial fractures taken for surgery early after anaesthetic assessment, minimally invasive plate osteosynthesis done biologically yields good results. CONCLUSION: Distal tibial fractures pose a great challenge to an orthopaedic surgeon, since most of them are high velocity injury with cross soft tissue swelling. In the present study, the distal tibial biological locking plate technique achieved acceptable results both clinically and radiologically. As it reduces surgical trauma to soft tissue and retains vascularity of the fragments while providing rigidity of fracture fragments.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Distal tibial fractures ; dia-metaphyseal ; high velocity injury ; soft tissue damage ; minimally invasive plate osteosynthesis ; pre contoured distal tibial medial locking plate ; bulky implant ; wound infection.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 25 Sep 2017 03:35
Last Modified: 04 May 2018 17:05
URI: http://repository-tnmgrmu.ac.in/id/eprint/3324

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