A prospective study of surgical management of tibial plateau fractures by locking compression plate

Abstract

Aim: To assess the clinical and functional outcome of surgically treated tibial plateau fractures with internal fixation by locking compression plated at SSIMS-RC, DAVANAGERE during JUNE 2015 TO FEBRUARY 2017. Objectives 1. To re-establish the anatomy of articular surface of upper end of tibia and knee joint perfectly by operative treatment with internal fixation. 2. To assess the radiological union of fractures after internal fixation with locking compression plate. 3. To assess the functional outcome of knee joint Materials and methods: Total number of cases studied were 30. Inclusion criteria: Skeletally mature patients with tibial plateau fractures. Exclusion Criteria: Patients with Gustilo- Anderson Type 3 compound tibial plateau fractures, Children with proximal tibial fractures in whom the growth plate is intact, patients with pathological proximal tibial fractures apart from osteoporosis, Patients managed conservatively for other medical comorbidities, Ipsilateral intraarticular fracture femur and patella. Observation and results: Rassmussens criteria was used for evaluation of results. Out of 30 cases., we are able to achieve 66.66% excellent result and 20% good result( over all 86.66%, acceptable results ) with our standard surgical care. in addition we have 13.33% fair and results interm of functional outcome. Conclusion: From this study we conclude that, surgical management of tibial plateau fractures gives excellent anatomic reduction, accurate axial and articular alignment with rigid internal fixation by locking compression plate and achieves a stable and functional knee joint. Preoperative soft tissue status and associated ligamentous injuries and their repair at right time, significantly changes the final outcome.