A study of tibia plateau fractures treated with locking tibia plate: A study of 63 cases

Abstract

Objectives: To evaluate the results of locking plate system for tibia plateau fractures in Indian population with emphasis on functional outcome, soft tissue complications, rate of infection and time to union.Introduction: Tibia plateau fractures are resulting from a combination of axial loading with varus or valgus stress. Inadequate and inappropriate treatment may result in significant functional loss. Tibia plateau fractures are difficult lesions to treat because of the involvement of the articular surface, the often occurring comminution, and the precarious condition of the soft tissues, especially following high-energy trauma.Materials and Methods: A cohort of 63 tibia plateau fractures, surgically treated, from July 2013 to December 2015, was reviewed with a minimum 6 months up to maximum 2 years. Fractures were classified according the Schatzker classification. The assessment of the functional outcome was done with the use of the modified Rasmussen’s clinical and radiological score. Results: According to modified Rasmussen's scoring system, 40% patients had excellent results, 39% had good results, 11% had fair results and 10% had poor results. In our study of 63 patients, 38 were managed by MIPPO reduction, 25 were managed by ORIF. Median age of the patients was 37 years. The average time to union was 12.88 weeks. Infection was seen in 5 cases, Varus deformity in 2 cases, Knee joint stiffness in 3 cases and Implant Failure in 2 cases. Poor results were associated with high energy fractures and inadequate physiotherapy follow-up. Conclusions: Locking plates especially by MIPPO technique gives excellent results in tibia plateau fractures with minimum complications. Achieving and maintaining anatomical reduction becomes easy with locking plates, which helps in early mobilization and hence obtaining good functional outcome and there is no substitute for early physiotherapy.