Study of operative outcomes of proximal tibia fractures treated with locking plates
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20242390Keywords:
Internal fixation, Open reduction, Proximal tibial fractures, Schatzker classificationAbstract
Background: In this study we have studied the functional outcome of proximal tibial fractures treated by open reduction and internal fixation treated with locking compression plates after a minimum follow up period of 6 months.
Methods: We conducted the study of 50 patients that aimed at assessing the functional outcomes of radiologically confirmed proximal tibia fracture (both intra articular and extra articular) treated using locking compression plates, between July 2020 to May 2022 at Department of Orthopaedics in our Institute. The Schatzker classification was used for classifying the fractures and planning the treatment strategy using plain radiographs and CT scan films. The treatment modality was decided after classifying the type of fracture, the displacement, and the amount of depression of the tibial plateau, in our study, we included only those patients who were undergone ORIF or MIPPO for definitive treatment.
Results: Maximum number of patients (total 12) were in age group of 41-50 years (24%). Out of total 51 proximal tibia fractures, 4 (7.8%) were of type 1 variety, 12 (23.52%) were of type 2 variety, 2 (5.8%) were of type 3 variety, 4 (7.8%) were of type 4 variety, 6 (11.76%) were of type 5 variety and 9 (17.64%) were of type 6 variety according to Schatzker classification. out of 50 patients treated with locking compression plates, 26 patients (52%) showed excellent outcome with score between 28-30; 17 patients (34%) showed good outcome with score between 24-27; 7 patients (14%) showed fair results with score between 20-23, according to Modified Rasmussen’s scoring system.
Conclusions: Locking compression plates (LCP) for the treatment of the proximal tibia fractures including difficult fracture situations seem to be good implant of choice for better post operative outcomes.
References
Egol KA, Koval KJ, Zuckerman JD. Handbook of fractures. 4th ed. Wolters Kluwer Health; 2010: 455-464.
Schulak DJ, Gunn DR. Fracture of the tibial plateaus. Clin Orthop. 1975;109:166-77.
Koval KJ, Hulfut DL. Tibial plateau fracture: evaluation and treatment. J Am Acad Orthop Surg. 1995;3(2):86-94.
Biyani A, Reddy NS, Chaudhury J, Simison AJ, Klenerman L. The results of surgical management of displaced tibial plateau fracture in the elderly. Injury. 1995;26(5):291-7.
Schatzker J. The rationale of operative fracture care. vol. Volume 3. New York, NY: Springer; 2005: 447-69.
Marsh JL. Tibial plateau fractures. In: Rockwood and Green’s fracture in adults. Wolters Kluwer; 2015:2303-67.
Liu YK, Zhou ZY, Liu F. New developments in treatments of tibial plateau fractures. Chin Med J. 2017;130(21):2635-8.
Vadadoriya K, Chatterjee R, Sarkar T, Mukherjee S, Sengupta A, Hashib G, et al. Study of functional outcome of tibial plateau fractures treated with anatomical contoured locking compression plate. Ind J Orthopaed Surg. 2023;7(4):280-90.
Musahl V, Tarkin I, Kobbe P, Tzioupis PC, Siska A, Pape H. New trends and techniques in open reduction and internal fixation of fractures of the tibial plateau. J Bone Joint Surg. 2009;91(4):426-33.
Hassankhani EG, Kashani FO, Hassankhani GG. Treatment of complex proximal tibial fractures (types V & VI of Schautzker classification) by double plate fixation with single anterior incision. Open J Orthop. 2013;3(4):208-12.
Ricci WM, Rudzki JR, Borrelli Jr J. Treatment of complex proximal tibia fractures with the less invasive skeletal stabilization system. J Orthop Trau. 2004;18(8):521-7.
Hu YL, Ye FG, Ji AY, Qiao GX, Liu HF. Three-dimensional computed tomography imaging increases the reliability of classification systems for tibial plateau fractures. Injury. 2009;40(12):1282-5.
Gaston P, Will EM, Keating JF. Recovery of knee function following fracture of the tibial plateau. J Bone Joint Surg Br. 2005;87(9):1233-6.
Honkonen SE, Kannus P, Natri A, Latvala K, Järvinen MJ. Isokinetic performance of the thigh muscles after tibial plateau fractures. Int Orthop. 1997;21:323-6.
Schwartsman R, Brinker MR, Beaver R, Cox DD. Patient self- assessment of tibial plateau fractures in 40 older adults. Am J Orthop (Belle Mead NJ) 1998;27(7):512-9.
Rademakers MV, Kerkhoffs GM, Sierevelt IN, Raaymakers EL, Marti RK. Operative treatment of 109 tibial plateau fractures: five- to 27-year follow-up results. J Orthop Trauma. 2007;21(1):218.
Sangwan SS, Siwach RC, Singh R, Mittal R. Minimal invasive osteosynthesis: a biological approach in treatment of tibial plateau fractures. Indian J Orthop. 2002;36(4):246-50.
Singh SJ, Chandranna B. A study of surgical management of proximal tibia fractures treated with locking compression plate. Int J Adv Res. 2020;8(5):198-202.
