Supercutaneous plating: A case report of locking plate used as an external fixator

Abstract

Introduction: Proximal and distal tibial fractures with a compromised soft tissue envelop still pose a treatment dilemma or challenge for the orthopedic surgeon LCPs have advantages of angular stability from the locking-head mechanism and less irritation when compared with traditional external fixators due to their low profiles. Here is a poster case report of the same.Case Report: A 37-year-old male, flouriest, from Badravathi who came to Orthopedic OPD after he had met with a road traffic accident on 23rd November 2020 and sustained injury to left leg. Plain radiograph revealed fracture of left tibia and fibula at the proximal and middle third junction. Arterial Doppler showed long segment poplitial artery thrombosis.As a definitive treatment patient underwent Open reduction and plate fixation of proximal third tibia with thromboembolectomy and venous grafting done. The limb post-operative went into compartment syndrome and emergency fasciotomy of left leg wasdone. Fasciotomy wound got infected and hence Vacuum assisted closure was applied. The same locking plate was removed and used as an external fixator. The External fixation plate for left tibia was removed and the patient was put on patellar tendon bearing cast and is showing good signs of union.Conclusion: For proximal fractures of the tibia, which are treated by external fixation using the LCP plate is a safe and reliable technique and excellent functional outcomes. There is a high rate of union with minimal complications rate. Its advantages also include ease of performing surgery and ease of removing plate after fracture healing. Though the use of locked plates as external fixators is not a generally acknowledged technique by many surgeons still it has become valuable modality in management.