A PROSPECTIVE RANDOMISED CLINICAL TRIAL TO EVALUATE THE EFFECT OF FIBULAR PLATING IN TWO STAGED TREATMENT OF TIBIAL PLAFOND FRACTURES

Abstract

Introduction: A single blinded randomized clinical trial of distal plafond fractures , who were treated with primary external xation with and without bular plating followed by distal tibial plating .Sincere efforts were made to analyze and compare the results of bular xation and staged protocol in tibial plafond fractures. A prospective study was Materials and Methods: conducted for 40 cases of tibial plafond fractures who were aged between 18yrs - 65yrs and presented within 2 weeks of injury. Randomization was done to allocate 20 patients each into two treatment models – a)External xation with bular plating , b)External xation without bular plating. Second stage distal tibial lock plating was done in all cases and follow up was carried out. Results: Statistically signicant differences were found in case of operating time, duration of hospital stay in favour of external xation without bula plating group, but these may not be clinically signicant. Delay in second stage tibial plating was more in bular plating group. Fibula plating reduces rotational malalignment more signicantly than coronal and saggital plane malalignment. There is no signicant early union , malunion or nonunion on comparing both groups. Both the procedures gave equally good functional results. We recommend two stage protoc Conclusion: ol for management of plafond fracture to decrease complication rate and bular xation is not always necessary in those cases with undisplaced lateral column. Displaced bular fractures which destabilize the ankle mortise should always be picked up for bular plating.