The Role of Early Mobilization in Outcome of Proximal Tibia Fractures Treated with Dual Plating

Abstract

The management of bicondylar fracture of the proximal tibia is a challenging task and the aim of management is to achieve stable, painless and mobile joint and also to prevent the secondary degeneration of the joint. Open reduction and internal fixation with dual plating in such fractures is beneficial to address fracture fragments in different planes and also to achieve anatomical reduction under direct vision. It also allows stabilizing the fracture which helps in early mobilization of the patient. Early post-op rehabilitation is one the most important factor that play a vital role in outcome of the operated knees by preventing the post- operative stiffness and achieving good range of motion. This is a retrospective study conducted in Department of Orthopedic Surgery, Kurmitola General Hospital, Dhaka, Bangladesh from July to December 2022. Total 100 patients were included in the study. The functional outcome was evaluated according to Rasmussen scoring system. Mal-reduction of the articular surface was defined as an intra- articular step-off of at least 2 mm measured on scaled radiographs. Oldest patient was 71 years and youngest patient was 20 years old. Male were 79% and female were 21%. All the patients with bicondylar fracture treated with dual plating. Data was obtained from the Medical record department, indoor ward records, OPD registers and Operation theatre records. This study analyses the outcome of bicondylar proximal tibia fracture treated with dual plating in 100 patients. In our series we found 63 % excellent results and 28 % good results, while 7 % and 2% fair and poor outcome respectively. Fractures of proximal tibia are increasing with the increase in mechanization and increased road traffic in current world today. These fractures are more in men and those who use automobiles frequently for their outdoor ventures. Better preoperative planning in selection of approach can minimize the soft tissue injury and unnecessary periosteal stripping. ......