scholarly journals Result of Ring Fixator in High-energy Schatzker Type VI Fractures of Proximal Tibia

2021 ◽  
pp. 451-459
Author(s):  
Aftab Alam Khanzada ◽  
Muhammad Rafique Joyo ◽  
Muhammad Imran Javed ◽  
Nizam Ahmed ◽  
Niaz Hussain Keerio ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Tissue Damage ◽  
Proximal Tibia ◽  
High Energy ◽  
Soft Tissue Damage ◽  
Soft Tissue Envelope ◽  
Ring Fixator ◽  
Schatzker Type ◽  
Tibia Fractures ◽  
Proximal Tibia Fractures

Background: Significant articular depression, separation of both condyles, diaphyseal comminution and dissociation, and loss of soft-tissue envelope integrity are all associated with high-energy proximal tibia fractures (Schatzker VI). Over the past 50 years, there has been a lot of research on plating problems in these complicated fractures. For the care of these complex injuries, Ilizarov devised a new method (ring fixator). Aim of the Study: To examine the outcomes of patients who received a ring fixator for the treatment of high-energy proximal tibia fractures (Schatzker VI). Materials and Methods: Fourteen patients (mean age 36) were treated with the Ilizarov fixator and transfixion wires for high-energy fractures of the proximal tibia (Schatzker VI). Nine of the patients had open fractures, and five of them had significant soft tissue damage. They were all tracked for an average of 19.4 months. The result was analyzed using the criteria set by Honkonen & Jarvinen (1992). Results: Thirteen fractures healed in an average of 14.6 weeks, with one taking six months. Twelve patients recovered complete extension, while eight others regained more than 110 degrees of flexion. All of the patients knees were stable, except one who had a minor varus deformity. Nine patients walked normally, while four had a little limp. Except for one, all of the knees exhibited an articular step-off of less than 4 mm and normal axial alignment. Six knees were found to be outstanding, five to be decent, and three to be fair. There were no instances of postoperative skin infection or septic arthritis, however, three patients did have a pin tract infection that was effectively managed. Conclusion: The technique is suitable for the treatment of complex proximal tibia fractures when there is substantial comminution at the fracture site as well as soft tissue damage (Schatzker VI).

Staged Management of High Energy Proximal Tibia Fractures with Severe Soft Tissue Damage

2009 ◽  
Vol 22 (3) ◽  
pp. 152
Author(s):  
Seung-Ryul Lee ◽  
Jae-Hoon Yang ◽  
June-Kyu Lee ◽  
Hyun-Dae Shin ◽  
Kyung-Cheon Kim ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Tissue Damage ◽  
Proximal Tibia ◽  
High Energy ◽  
Soft Tissue Damage ◽  
Tibia Fractures ◽  
Proximal Tibia Fractures ◽  
Severe Soft Tissue

DEFINING “IMPENDING” COMPARTMENT SYNDROME AND DEVELOPING INDIAN DISTRICT HOSPITAL PROTOCOL FOR HIGH ENERGY PROXIMAL TIBIA FRACTURES.

2021 ◽  
pp. 66-70
Author(s):  
Nirjhar Maji ◽  
Anurag Das ◽  
Kuntal Bakuli
Keyword(s):  
Soft Tissue ◽  
Compartment Syndrome ◽  
Urban Areas ◽  
Soft Tissues ◽  
Proximal Tibia ◽  
District Hospital ◽  
Initial Period ◽  
High Energy ◽  
Tibia Fractures ◽  
Proximal Tibia Fractures

Background and objectives: High energy proximal tibia fractures (OTA 41/Schatzker 4/5/6) are common in motorbike accidents even in semi urban and sub-urban areas. Recommended management involves two stages with conventional Mantra of 'Span-Scan-Plan'. First stage involves temporary knee spanning external xator to prevent or manage impending compartment syndrome. This is followed by CTScan. The second stage is the denitive internal xation. These recommendations are not universally followed due to certain infrastructural and acceptability constraints inuencing decision making. Summary: The study is designed as prospective observational study. It is conducted in a District Hospital setup. An effort to dene and recognise “Impending Compartment Syndrome” is made by developing a clinical criteria based evaluation score. This score was used to monitor fracture related soft tissue changes over the initial period until denitive xation. All patients underwent temporary stabilisation by different methods. These different temporary xation methods were compared amongst each other to nd out their efcacy. Patient was assessed to the end point of where soft tissues settled down for denitive xation. Surgical site infection and knee function was assessed to nd out whether the type of temporary xation had any subsequent on soft tissue and knee joint. The results were statistically analysed to nd out clinical signicance.

scholarly journals Bilateral Gastrocnemius Flap For Harlequin Defects Around The Knee

2020 ◽  
Vol 6 (1) ◽  
pp. 248-253
Author(s):  
Tarun Chabra ◽  
Venkatramani Hari ◽  
Sabapathy SR
Keyword(s):  
Soft Tissue ◽  
Proximal Tibia ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
High Energy ◽  
Tissue Loss ◽  
Lateral Side ◽  
Gastrocnemius Flap ◽  
Schatzker Type ◽  
The Mean

Background : Tibial plateau fractures (especially bicondylar Schatzker type 5 and type 6) are a result of high energy trauma. Along with bony component, soft tissue injury is a major determinant in the treatment and final outcome. Bicondylar fractures needs bicolumnar fixation and as such require separate approaches: postero-medial and lateral incisions. The soft tissue of the proximal tibia swells significantly after the injury, coupled with extensive soft tissue dissection during fixation this can lead to subsequent wound breakdown and infection along either side of the proximal tibia which resembles “harlequin eyes”. This study describes outcome of management of post operative soft tissue complications following bicolumnar fixation of proximal tibia with medial and lateral gastrocnemius flap. Method : Three patients who had bilateral soft tissue necrosis at surgical incision sites treated with debridement and bilateral gastrocnemius flaps between January 2016 and December 2017 were included in this study. The mean age was 38 years (range 18–50 years) and the mean duration of follow-up was 10 months. Outcome assessments included the condition of the flap and fracture healing time. Result : All fractures united after surgery. There were no soft tissue complications and all flaps healed well. The mean bony union time was 6 months. Conclusion: Our technique of covering soft tissue loss at surgical site on medial and lateral side of proximal tibia with bilateral gastrocnemius flap in the same setting is a reliable and safe surgical method for these conditions.

Staged Management of High-Energy Proximal Tibia Fractures (OTA Types 41)

2005 ◽  
Vol 19 (7) ◽  
pp. 448-455 ◽  
Author(s):  
Kenneth A Egol ◽  
Nirmal C Tejwani ◽  
Edward L Capla ◽  
Philip L Wolinsky ◽  
Kenneth J Koval
Keyword(s):  
Proximal Tibia ◽  
High Energy ◽  
Tibia Fractures ◽  
Proximal Tibia Fractures

Strategies to minimize soft tissues and septic complications in staged management of high-energy proximal tibia fractures

2020 ◽  
Vol 30 (4) ◽  
pp. 671-680 ◽  
Author(s):  
Gianluca Canton ◽  
Federico Santolini ◽  
Marco Stella ◽  
Antonio Moretti ◽  
Michele Francesco Surace ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Proximal Tibia ◽  
High Energy ◽  
Septic Complications ◽  
Tibia Fractures ◽  
Proximal Tibia Fractures

FUNCTIONAL OUTCOME OF DISTAL TIBIA FRACTURES MANAGED WITH HYBRID RING FIXATOR

2021 ◽  
pp. 59-62
Author(s):  
Saksham Sharma ◽  
Rakesh Verma ◽  
Rahul Choudhary ◽  
Shiv Bhagwan Sharma
Keyword(s):  
Distal Tibia ◽  
High Energy ◽  
High Energy Trauma ◽  
Soft Tissue Envelope ◽  
Ring Fixator ◽  
Medical College ◽  
Tibia Fractures ◽  
Distal Tibia Fractures ◽  
The Common ◽  
Hybrid Ring

Introduction : distal tibia fractures are amongst the common open fractures encountered in day to day life owing to high energy trauma , the challenge to achieve union is added on due to absence of soft tissue envelope surrounding the bone apart from biological low blood supply Material and methods: this study was done in SRG Hospital and medical college , Jhalawar Rajasthan , comprising of 25 patients with open extra articular distal tibia fractures. Treated by reduction and external xation with ring hybrid xator. Results: The results were based on the objective and subjective parameters as described by Ovadia DN and Beals RK , we had 14 (56%) patients with excellent, 5 (20%) patient with good, 5 (20%) patients with fair and 1 (4%) patient with a poor outcome.

Clinical and Radiological Outcome of Complex Proximal Tibia Fractures Managed with Hybrid/Ilizarov Fixator with or without Minimal Internal Fixation

2021 ◽  
Vol 23 (4) ◽  
pp. 279-285
Author(s):  
Atmananda S. Hegde ◽  
Arkesh Madegowda ◽  
Vikrant Khanna ◽  
Seetharam Rao
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
Closed Reduction ◽  
Proximal Tibia ◽  
Tertiary Care ◽  
High Grade ◽  
Tibia Fractures ◽  
Ilizarov Fixator ◽  
Proximal Tibia Fractures

Background. Complex high grade proximal tibia fractures with associated extensive soft tissue injury pose a management challenge. The timing of surgery and fracture fixation options depend upon the extent of soft tissue damage. Post-operative complications such as wound breakdown, infection and infected non-union are common in such cases managed early with open reduction and internal fixation. Such fractures can be treated with primary closed reduction and Ilizarov/hybrid fixator application. Materials and methods. It is a retrospective cross sectional study conducted at two tertiary care multispecialty hospitals to report the mid-term clinical and radiological outcomes of complex high grade proximal tibia fractures. These injuries were managed by closed reduction and external fixation with/without minimal internal fixation as a definitive procedure and outcome measures were checked with serial radiographs and functional scores at a regular interval of follow up. 17 patients with Schatzker’s type 5 or 6 proximal tibia fractures with soft tissue compromise were operated on at two tertiary care referral centres from 2017 to 2019. These cases were operated on by two experienced trauma surgeons. Periodic follow-up was done and radiological and functional progression noted from case records. Results. Average time to union was noted to be 12.59 weeks and mean time of fixator removal was 21.4 weeks. At the end of 1 year of follow-up, average range of motion was 121.76 degrees, average WOMAC score was 74.81(63-82) and KOOS score was 78.24(63-85). Conclusions. 1. Hybrid/Ilizarov fixator method is a safe way of fixing high energy proximal tibia fractures. It is associated with a good functional outcome, less soft tissue complications and allows early weight bearing. 2. We recommend this method of treatment for complex high grade proximal tibia fractures.

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