scholarly journals Prospective study to measure the functional outcome of tibial plateau fractures

2019 ◽  
Vol 5 (6) ◽  
pp. 1061
Author(s):  
Anand Mohan Kayath ◽  
Ankit Kumar Kayathwal
Keyword(s):  
Prospective Study ◽  
Functional Outcome ◽  
Tibial Plateau ◽  
Plate Osteosynthesis ◽  
Single Case ◽  
Excellent Result ◽  
Tibial Plateau Fractures ◽  
Successful Outcome ◽  
Range Of Movement ◽  
Low Velocity

<p class="abstract"><strong>Background:</strong> Tibial plateau fractures are complex injuries of the knee. The tibial plateau is one of the most critical load-bearing areas in the human body. Early detection and appropriate treatment of these fractures are essential in minimizing patient's disability in range of movement, stability and reducing the risk of documented complications. The aim of the present study is to study the outcome of tibial plateau fractures and their management.</p><p class="abstract"><strong>Methods:</strong> This is prospective study which comprises of 50 patients with displaced tibial plateau fracture and were treated between January 2018 to December 2018 with minimal invasive percutaneous plate osteosynthesis and cortico-cancellous screw fixation. Statistical analysis was done by Chi-square test and IBM SPSS software.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our study we included 50 cases, treated with surgical procedure, 30 cases gave excellent result, 16 cases came out with good result, fair in 3 cases and 1 case had poor result. High velocity injuries have poor outcome than low velocity injuries. A single case of malunion was noted in study. Four cases had knee joint stiffness.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that functional outcome is good in operatively treated patients. Early physiotherapy plays key role in preventing knee stiffness, use of bone grafts and good fixation important for successful outcome.</p>

scholarly journals A prospective study of management of tibial plateau fractures by locking compression plate in adults

2021 ◽  
Author(s):  
Satish R. Gawali ◽  
Pradeepkumar S. Nair ◽  
Venktesh D. Sonkawade
Keyword(s):  
Tibial Plateau ◽  
Single Case ◽  
Tertiary Care ◽  
Tibial Plateau Fractures ◽  
Successful Outcome ◽  
Range Of Movement ◽  
Non Union ◽  
Anatomic Reduction ◽  
Management Protocol ◽  
Compression Plate

<p class="abstract"><strong>Background:</strong> Tibial plateau fractures are one of the most complex and disabling fractures of the knee. The tibial plateau is important in transmitting load through the knee. These fractures need a meticulous management protocol in order to minimize patient's disability in range of movement, stability and reducing the risk of documented complications. The aim of the present study is to study the outcome of tibial plateau fractures managed with a locked compression plate.</p><p class="abstract"><strong>Methods:</strong> This study was conducted at a tertiary-care medical college and hospital, Aurangabad specializing in post-graduate training, where all patients who underwent surgical treatment between September 2018 and October 2020 were included. Patients were assessed using the knee society score (KSS). These evaluations were done at 1, 3, 6, 9 and 12 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our study we included 55 patients out of which we found union in 98% of patients with 83% of patients showing good flexion at knee joint (&gt;110 degrees). 85% patients achieved union within 6 months. An excellent KSS grade was seen in 38.2% patients with another 43.6% showing good outcome. 4 patients showed infection and 1 showed non-union. A single case of malunion was seen in our study.</p><p class="abstract"><strong>Conclusions:</strong> Locked compression plates in tibial plateau fractures has revolutionized the way these fractures are managed. Anatomic reduction is of utmost importance. Early physiotherapy which plays key role in preventing knee stiffness, use of bone grafts and good fixation are important for successful outcome.</p>

scholarly journals To analyze the functional outcome of proximal tibial fractures treated with minimally invasive percutaneous plate osteosynthesis technique

2017 ◽  
Vol 3 (6) ◽  
pp. 1205
Author(s):  
Sivakumar Arumugam ◽  
Venkateshwara Arumugam ◽  
V. Raviraman
Keyword(s):  
Minimally Invasive ◽  
Functional Outcome ◽  
Tibial Plateau ◽  
Plate Osteosynthesis ◽  
High Energy ◽  
Tibial Plateau Fractures ◽  
Tibial Fractures ◽  
Soft Tissue Dissection ◽  
Proximal Tibial Fractures ◽  
Walking Capacity

<p class="abstract"><strong>Background:</strong> Tibial plateau fractures constitute about 1% of all fractures and complex bicondylar fractures constitute 30% of all Tibial plateau fractures. Minimally Invasive Percutaneous Plate Osteosynthesis [MIPPO] is a method of biological fixation in which a plate is percutaneously inserted and fixed at a distance proximally and distally from the fracture site. By minimal exposure, this helps in the preservation of the essential fracture hematoma, minimal soft tissue dissection, avoidance of periosteal stripping and providing an adequate fixation. The objective of the study was to analyze the functional outcome of proximal Tibial fractures treated with MIPPO technique. The method of fixation shall be evaluated for the time period required for the patients to return to active work following surgery.</p><p class="abstract"><strong>Methods:</strong> In our study, all 18 patients with proximal Tibial fractures underwent definitive fixation by MIPPO technique. All our cases underwent initial stabilization as per the ATLS guidelines. Patients with closed Tibial plateau fractures associated with a tense haemarthrosis underwent aspiration of the joint under aseptic precautions. The limb was immobilized either in an above knee slab or through skeletal traction using a distal Tibial or calcaneal pin traction on a Bohler Braun splint until definitive fixation was carried out. In cases complicated with excessive swelling and blistering, definitive fixation was delayed until the swelling/ blistering subsided.<strong></strong></p><p class="abstract"><strong>Results:</strong> The post-operative results were designated as excellent, good, fair and poor according to pain, walking capacity, the range of motion and stability of the knee using Rasmussen’s grading system. In our study, the average functional knee score was 22.89. Rasmussen’s score does not consider articular congruity while assessing the functional outcome of the knee.</p><p class="abstract"><strong>Conclusions:</strong> MIPPO technique gives good to excellent results even in high energy Tibial condyle fractures [72.22% cases in our study]. Our patients were able to achieve a good functional range of movement, averaging 120 degrees. [Krettek et al – 124 degrees]. Those who were treated with early fixation and early mobilization were found to have a better functional outcome irrespective of the fracture type. No secondary bone grafting was required. </p>

scholarly journals Prospective study of management of Schatzker’s type V & VI tibial plateau fractures by different types of plate osteosynthesis

2017 ◽  
Vol 3 (5) ◽  
pp. 1070
Author(s):  
Siddaram N. Patil ◽  
Pandurangaiah Srinivas ◽  
Divya Bhandary
Keyword(s):  
Prospective Study ◽  
Tibial Plateau ◽  
Locking Plate ◽  
Plate Osteosynthesis ◽  
Tibial Plateau Fractures ◽  
Dual Plating ◽  
Different Types ◽  
Dual Incision ◽  
Type V ◽  
Hss Score

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Schatzker‘s type V and type VI fractures are bicondylar tibial plateau fractures which pose a challenge to the treating orthopaedician. Several studies have compared unilateral locked plate and double plating for their treatment and showed no statistically significant difference between these two fixation methods. So the quest for ideal implant for internal fixation (unilateral plating and dual plating) of these fractures continues. Hence we decided to do this study.</span></p><p class="abstract"><strong>Methods:</strong> A prospective study of Surgical Management of thirty seven cases of Schatzker’s type V and VI tibial plateau fractures by different types of plate osteosynthesis (single unilateral locking plate and dual incision locking buttress plate) was carried out. The functional outcomes were assessed by the hospital for special surgery knee score system.<strong></strong></p><p class="abstract"><strong>Results:</strong> 18 patients were fixed with a unilateral locking plate, 19 patients were fixed with a dual incision bilateral locking plates. All patients had satisfactory articular surface reduction and axis of alignment on immediate postoperative radiographs. All cases achieved union by 4.8 months approximately. All patients had either excellent or good HSS score. Mean HSS score at recent follow-up was 86.10 in DP group and 83 in SP groups (t value 2.81, p values 0.008)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> We conclude that single plating and dual plating fixation of complex proximal tibial plateau fracture Schatzker‘s type 5 and type 6 ensures stable fixation, immediate mobilization, satisfactory radiological outcome, very high union rates and excellent functional assessment outcome with a very low rate of complications<span lang="EN-IN">.</span></p>

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