To assess the functional outcome of tibial condyle fractures following open reduction and internal fixation with plate and screws -A prospective study

Abstract

Purpose: To evaluate the functional outcome of tibial plateau fractures treated by open reduction and internal fixation with buttress plating and cancellous screws. Methods: A prospective study of 25 patients with tibial condyle fractures treated by open reduction and internal fixation at the Government Medical College Trichur during year 2008-2010 was be considered for the study. Results: Functional grading was done based on. Modified knee scoring system of Hohl & Luck (1956) – (modified by Dennis Bo Jensen, Claus Raud et al) No patient had lack of extension i.e., all of them were able to extend. But range of movement was limited in few patients. 68% had more than 1200. 16% had < 1200 and > 900 movement and 12% having range of motion between 75 and 90 degrees. Similarly instability was not observed widely. Only 4% had > 5o of instability. 4% was unable to walk more than 100 m and all others were able to walk without much pain. Considering all parameters, the total pain score was assessed and 88% had no pain and 8% had mild pain and 4% had moderate pain. All the patients were assessed functionally and assigned grade for their performance. 68% performed excellently and 16% showed good performance and performance is fair only in 12% and 4% performed poor. All the patients were assessed radiologically and assigned grade for their performance. 92% performed excellently and 4% showed good performance and only 4% performed fair. Conclusion: The overall analysis of this study showed that the functional results were much better with types I, II, III and IV fractures than the complex fractures. Complication rates were also more with type V and VI fractures. Bicondylar fractures can be effectively treated by reduction and fixation with lateral locking plate Bone grafting after elevation of the depressed fracture is always advisable as it gives a good anatomical as well as functional outcome Post-operative /wound breakdown &infection is a major complication, The chance of infection, delayed wound healing and wound breakdown in complex tibial fractures (types IV, V and VI) are high.