1Senior Resident, Lady Hardinge Medical College, New Delhi
2Head, Department of Orthopaedics, VIMS, Bellary, Karnataka
3Associate Professor, Department of Orthopaedic, VIMS, Bellary, Karnataka
Fractures around knee are one of the commonest fractures encountered in high velocity trauma which are associated with high morbidity and mortality. This necessitates early stabilization of fractures. Internal fixation is the form of buttress plate and locking compression plate for closed fracture and hybrid external fixation for open gives promising result in fracture union, return to work and the functional outcome.
To study the functional results of complex tibial plateau fracture with different surgical procedures.
A Prospective Study.
At Vims Government Hospital Bellary. Methods: 25 cases of complex tibial plateau fracture (20 closed and 5 open) were treated by closed/open reduction and internal fixation by Locking Compression Plate, Buttress plate and hybrid external fixator between july 2009 & march 2012 at our institution. The patients were evaluated clinically and radiologically for outcomes. All patients were followed up for an average of 12 months. Outcome was assessed using NEER'S Score.
23 fractures healed within an average duration of 13 to 16 weeks following surgery. There was infection with in one case (tibal fracture-SchatzkerV), which was treated with second surgery using implant removal, orthofix and bone grafting and other case was loss reduction in hybrid external fixation treated with LCP with bone grafting for both tibial plateau and distal shaft tibia. Range of motion of knee & Hip was excellent to very good. Gait and weight bearing after complete union was satisfactory.
Closed/Open Reduction and Internal Fixation of Closed Complex Tibial Plateau Using Locking Compression Plate is one of the best modalities and superior to BUTRESS PLATE in treatment especially in intraarticular fractures where the maintenance of articular congruity is crucial. Fixation with locking compression plate showed more effectiveness in severly osteoporotic bones, shorter post-operative stay, faster recovery, earlier union rates and excellent functional outcome compared to buttress plate in our studies. In comparison to closed fractures all open fracture present with severe soft tissue insults so rather than going for multiple surgical procedure wound debridement and HYBRID EXTERNAL FIXATION is one of the best modalities. Hybrid external fixator provide rigid fracture fixation and allow early mobilization of knee.
Complex Tibial Plateau Fracture, Locking Compression Plate, Buttress Plate, Hybrid External Fixation, MIPO, Early Post-Operative Mobilization, Weight Bearing
