Short term outcome analysis of proximal tibia fractures treated with minimally invasive plate osteosynthesis

Abstract

Introduction: Proximal tibial fractures caused by high-energy mechanisms are associated with neurovascular injuries, compartment syndrome, deep vein thrombosis, contusion, crush injury to the soft tissues and open wounds. Management of proximal tibia fractures are difficult considering the limited soft tissue cover over the shin of tibia and vascular compromise following injury. Open reduction and internal fixation in oedematous vascular compromised skin will end up in complications like infection and wound dehiscence. Management of proximal tibia fractures using minimally invasive plate osteosynthesis reduces damage to surrounding soft tissues and helps in improved fracture healing without complications. Analysis of functional and radiological outcome along with the complications of proximal tibial fractures treated by minimally invasive plate osteosynthesis using Knee Society Score. Materials & Methods: We have analysed 20 cases of proximal tibial fractures treated surgically using minimally invasive plate osteosynthesis admitted in our Institute between January 2016 and December 2017. All patients were preoperatively assessed radiologically and classified and managed by MIPO technique and outcome was analysed by Knee Society score. Results: Majority of injured patients were male (90%) and the highest number of patients were in their 4th decade (60%). Road traffic accidents was the most common mode of injury (80%). Type VI fracture is the most common type in 60% patients. Early complications like wound gaping, skin necrosis were treated. Average time from injury to surgery was 10 days. All of our patient’s results were excellent and good. The average knee society score in our study with 20 patients was 81. All fractures united after an average of 20 weeks. The mean time to full, unprotected weight bearing was 16 weeks. Conclusion: Proximal Tibial fractures treated surgically using minimally invasive plate osteosynthesis technique gives early functional ability and early mobilisation of knee joint. Minimally invasive plate osteosynthesis technique offers improved fracture healing without any risk of soft tissue complications when compared to conventional plating by open reduction and internal fixation.