A Prospective study of functional outcome of bicondylar tibial plateau fracture managed with locking compression plate

Subramani, R (2015) A Prospective study of functional outcome of bicondylar tibial plateau fracture managed with locking compression plate. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.


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INTRODUCTION: Tibial plateau fractures account for 1% of all fractures in adults and 8% in elderly. Fractures of tibial plateau more common in recent days due to increasing number of road traffic accidents. These fractures resulting from direct axial compression (valgus) and indirect coronal forces. The injuries span a wide spectrum, ranging from low energy unicondylar fractures to high energy bicondylar and comminuted fractures. In addition, in elderly with osteoporotic bones, even low energy injuries such as domestic falls may lead to complex tibial plateau fractures. Hence the treatment of proximal tibial fractures has become a challenge for the orthopaedic surgeons. LCP has the advantages of better distribution of forces along the axis of bone. They can be inserted with minimal soft tissue stripping using minimally invasive percutaneous plate osteosynthesis (MIPPO). Substantially reducing failure of fixation in osteoporotic bones. Reducing the risk of a secondary loss of intraoperative reduction by locking with screws to the plate. Unicortical fixation option. Better preservation of blood supply to the bone as a locked plating does not rely on plate bone compression. Provide stable fixation by creating a fixed angle construct and angular stability. LCP is technically mature and as it offers numerous fixation possibilities and has proven to worth in complex fracture situations and in osteoporotic bones. AIM OF THE STUDY: This prospective study aims at evaluating the functional outcome of schatzker type V and VI tibial plateau fracture treated by locking compression plate at Department of orthopaedics and Traumatology ,Govt Mohan Kumaramangalam Medical college and Hospital ,Salem Between May 2012 and August 2014. MATERIALS AND METHODS Our study was a prospective study, conducted at the Department of Orthopedics and Traumatology, Government Mohan Kumaramangalam Medical College and Hospital, Salem between May 2012 and August 2014. Inclusion Criteria:  Schatzker type V and VI tibial plateau fractures,  Age > 18 years,  Closed fractures,  Grade I compound fractures. Exclusion criteria :  Age < 18 years,  Grade II and III compound fractures,  Associated with vascular injury,  Pathological fractures. DISCUSSION: We presented the clinical study of surgical treatment of 27 proximal tibial plateau fractures treated with locking compression plate ..The analysis of the results made in terms of age of patients, gender distribution , Laterality of fracture ,mode of injury , analysis of the types ,medial condyle fracture planes ,primary bone grafting ,method of reduction and fixation ,pre operative external fixation , dual plating , associated injuries and complications . In our study maximum incidence involving tibial plateau fracture >40 yrs (81%) . Average age group in our study was 51.25 years compared to Gosling et al 2005 study (Average age group 51.5 years) CONCLUSION: At the end of our study, following conclusions could be drawn from the treatment of proximal tibial fracture with locking compression plate.  Early mobilization is possible with LCP because of absolute stability given by the implant and this contributes to better knee range of motion .  Medial condyle coronal fracture and small posteromedial fragment should be buttressed by posteromedial plating .  LCP gives the promising results in osteoporotic bones .It prevents collapse of fracture both intraoperatively and postoperatively .  Not all bicondylar fractures are same ,treatment should be precise to individual fracture pattern .  Bicondylar tibial plateau fractures treated with locking compression plate have an excellent to good functional outcome with very minimal wound complications

Item Type: Thesis (Masters)
Uncontrolled Keywords: functional outcome ; bicondylar tibial plateau fracture ; management ; locking compression plate.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 26 Sep 2017 01:03
Last Modified: 26 Sep 2017 01:03
URI: http://repository-tnmgrmu.ac.in/id/eprint/3342

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