DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20181798

A prospective study to analyse the outcome of locking compression plating by minimally invasive percutaneous plate osteosynthesis technique in proximal tibial fractures

Anjaneyulu Reddy D., Krishna Redy P.

Abstract


Background: The proximal tibial fractures are one of the commonest intra articular fractures majority are of high energy fractures. We did the study to measure the outcome of locking compression plating by minimally invasive percutaeneous plate osteosynthesis technique in proximal tibial fractures.

Methods: Study comprises 20 cases of proximal tibial fractures, which have been managed by MIPPO technique during the period December 2014 to August 2016.

Results: The sex distribution in our study was 18 males and 2 females with 30 to 57 years age. The most common mode of injury in this study was road traffic accident. Type V Schatzker tibial plateau fractures were the commonest in 8 patients. 70% of our patients had excellent and good results in the functional outcome. In our study the average functional knee score was 22.40. The average range of movement achieved was 120 degrees. The average time taken for fracture healing was 16.52 weeks. In conclusion, MIPPO technique gives good to excellent results even in high energy tibial condyle fractures (70% cases in our study). Those who were treated with early fixation and early mobilization were found to have a better functional outcome irrespective of the fracture type. No secondary bone grafting was required.

Conclusions: The study reports that MIPPO technique is an effective method of treating proximal tibial fractures due to its overall good functional outcome.

 


Keywords


Proximal tibial fractures, Locking compression plating, Minimally invasive percutaneous plate osteosynthesis technique

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References


Starman JS, Castillo RC, Bosse MJ, MacKenzie EJ. LEAP Study Group. Proximal tibial metaphyseal fractures with severe soft tissue injury: clinical and functional results at 2 years. Clin Orthop Relat Res. 2010;468(6):1669–75.

Littenberg B, Weinstein L P, McCarren M, Mead T, Swiontkowski M F, Rudicel S A, Heck D. Closed fractures of the tibial shaft: Ameta-analysis of three methods of treatment. J Bone Joint Surg (Am). 1998;80:174–83.

Marsh JL, Smith ST, Do TT. External fixation and limited internal fixation for complex fractures of the tibial plateau. J Bone Joint Surg (Am). 1995;77:661–73.

Collinge C, Sanders R, DiPasquale T. Treatment of complex tibial periarticular fractures using percutaneous techniques. Clin Orthop. 2000;375:69–77.

Farouk O, Krettek C, Miclau T, Schandelmaier P, Guy P, Tscherne H. Minimally invasive plate osteosynthesis: does percutaneous plating disrupt femoral blood supply less than the traditional technique? J Orthop Trauma. 1999;13:401–6.

Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, In-Ho Jeon, Byung-Chul Park, Woo-Kie Min, et al. Double plating of unstable proximal tibial fractures using minimally invasive percutaneous osteosynthesis technique, Acta Orthopaedica. 2009;77:524-30.

Gautier E, Sommer C. Guidelines for the clinical application of the LCP. Injury. 2003;34:63-76.

Stoffel K, Dieter U, Stachowiak G, Gächter A, Kuster MS. Biomechanical testing of the LCP–how can stability in locked internal fixators be controlled? Injury. 2003;34:11-9.

Patil AB, Angadi VK, Nagnur R, Palled GS. Functional outcome of high energy tibial plateau fractures treated with different modalities. Int J Orthop. 2016;2(3):76-80.

Chintawar G, Deshpande S, Khan SM, Gawande V, Sharma A, Singh PK, et al. Evaluation of Outcome of Proximal Tibia Fractures managed with MIPPO. Indian J Orthop Surg. 2016;2(2):156-64.

Sharma P, Venkatachalam K, Pugazhendhi G, Madhukar. A prospective Study of the Functional Outcome of Locking Compression Plating for Closed Schatzker Type V and Type Vi Tibial Plateau Fractures. Sch Acad J Biosci. 2016;4(10):849-62.

Weil YA, Gardner MJ, Boraiah S, Helfet DL, Lorich DG. Posteromedial Supine Approach for Reduction and Fixation of Medial and Bicondylar Tibial Plateau Fractures. J Orthop Trauma 2008;22:357-62.

Barei DP, Nork SE, Mills WJ, Henley MB, Benirschke SK. Complications associated with internal fixation of high energy bicondylar tibial plateau fracture utilizing a two incision technique. J Orthop Trauma. 2004;18:649-57.

Sarmiento AU, Kinman PB, Latta LL, Eng P. Fracutres of the proximal tibia and tibial condyles: a clinical and laboratory comparative study. Clinical orthopaedics and related research. 1979;145:136-45.

Moore TM, Patzakis MJ, Harvey JP. Tibial plateau fractures: definition, demographics, treatment rationale, and long-term results of closed traction management or operative reduction. Journal of orthopaedic trauma. 1987;1(2):97-119.

Gaudinez RF, Mallik AR, Sporn M : Hybrid external fixation of comminuted tibial plateau fractures. Clin Orthop. 1996;328:293-310.

Krettek C, Gerich T, Miclau TH. A minimally invasive medial approach for proximal tibial fractures. Injury. 2001;32:S4-13.

Raza H, Hashmi P, Abbas K, Hafeez K. Minimally invasive plate osteosynthesis for tibial plateau fractures. J Orthop Surg. 2012;20:42-4.

Sonkar D, Bansal A, Shukla J, Gaur S. Functional outcome of locking compression plate osteosynthesis in schatzker’s type v and vi tibial plateau fractures. J Evol Med Dental Sci. 2015;4(89):15450-4.

Lee JA, Stamitios A, Papadakis, Moon C, Zalavras C, Tibial plateau fractures treated with minimally invasive percutaneous plate osteosynthesis. Int Orthoop. 2007;31:415-8.

Oh CW, Oh JK, Jeon IH, Kyung HS, Park IH, Park BC, Min WK, Lee JH. Double Plating of Proximal Tibial Fractures Using Minimally Invasive Percutaneous Osteosynthesis Technique. J Korean Fracture Society, 2005;18(3):250-5.

Cole PA, Zlowodski MA, Kregor P. Treatment of Tibial plateau fracture using Less invasive stabilization system, surgical experience and early clinical outcome in 77 fractures. J Orthop Trauma. 2004;18:528-35.