A study of management of fracture proximal tibia by different modalities

Abstract

The knee joint is one of the three major weight bearing joint in the lower extremity. Fractures that involve proximal tibia affect knee function and stability. These fractures can either be intra-articular or Extra-articular. Intra-articular fractures of proximal tibia are difficult to treat. Age, skin conditions, osteoporosis further increase the obstacles in the healing process. Various modalities of treatment are available but no ideal treatment has yet evolved. At the Chicago Orthopedic society in 1956 Manson Hole has rightly mentioned that “these fractures are tough” Complex kinematics of its weight bearing position and complex ligamentous stability and articular congruency are the main reason why these fractures are of concern to surgeon and cause disability to the patients. The mobility and stability of the lower limbs mostly depends upon a stable and functional knee joint. In most instances, intramedullary nailing has become the method of choice for the fixation of diaphyseal tibial fractures and has been extended to the treatment of proximal fractures. Reports have shown a high incidence of malalignment and loss of fixation associated with intramedullary nailing of proximal metaphyseal fractures.7Minimally invasive plate osteosynthesis techniques have recently been applied to fractures of proximal and distal tibia. Recently, the use of plate fixation utilizing minimally invasive techniques has been put forward as one way maintaining alignment in proximal tibial fractures. The purpose of this study is to study the available modalities of treatment of proximal tibia fracture in this institute and observe their functional result.