English

Abstract

BACKGROUND AND OBJECTIVE : Tibial plateau fractures are one of the commonest intra-articular fractures. It results from indirect coronal or direct axial compressive forces. It comprises of 1% of all fractures. These fractures encompass many and varied fracture configurations that involve medial, lateral or both plateaus with many degrees of articular depressions and displacements. Being one of the major weight bearing joints of the body, fractures around it will be of paramount importance. METHODS : 30 cases of tibial plateau fractures treated by various modalities were studied from September 2009 to september 2011 at Kempegoda Institute of Medical Sciences and followed for minimum of 6 months. RESULTS : The selected patients evaluated thoroughly clinically and radiologically, after the relevant lab investigations, were taken for surgery. The indicated fractures treated as per the SCHATZKER'S types, accordingly with CRIF with percutaneous cannulated cancellous screws, MIPPO with LCP/ Butress plate and screw, ORIF with buttress plate/ LCP and screw. Early range of motion started soon after the surgery. No weight bearing upto 6 weeks. The full weight bearing deferred until 12 weeks or complete fracture union. Immobilization in insecurely fixed fractures continued for 3-6 weeks by POP cast. The knee range of motion was excellent to very good, gait and weight bearing after complete union was satisfactory. Infection in two cases and stiffness in 2 cases were seen and there was no non-union in our cases. CONCLUSION: Surgical management of tibial condylar fractures will give excellent anatomical reduction and rigid fixation to restore articular congruity, facilitate early motion, hence to achieve optimal knee INTRODUCTION: Tibial plateau fractures are one of the commonest intra-articular fractures. It results from indirect coronal or direct axial compressive forces. It comprises of 1% of all fractures. These fractures encompass many and varied fracture configurations that involve medial, lateral or both plateaus with many degrees of articular depressions and displacements. Each fracture type has its own characteristic morphology and response to the treatment. It is essential to determine the force of injury since high-energy trauma is associated with considerable soft tissue and neurovascular damage. Apart from tibial plateau bony injury, meniscal tear and ligament injuries should also be assessed.1 The stationary lower limb may be struck by a moving object; this is the common pedestrian injury, the so called BUMPER FRACTURE, since the bumper of most vehicles being placed roughly at knee height. The exposed knee joint may be subjected to angulation, rotation or shearing strains and when the subject is upright, his body weight assists in the injury and he falls over. Fractures of the upper tibia are difficult to treat, apart from the usual problems of confining patients to bed. Conservative treatment at any age, may be complicated by knee stiffness, malunion