Surgical management of proximal tibial fractures with locking compression plate

Girisha B. A., Rajesh P., Satish Kumar C., Muralidhar N.


Background: Incidence of proximal tibial fractures is increasing due to increasing incidence of road traffic accidents (RTA). Knee joint being one of the major weight bearing joint of the body, appropriate management of fracture around it will be of paramount importance in maintaining mobility. The recent development of locking compression plate (LCP) has revolutionized the treatment of proximal tibial fractures by overcoming the few drawbacks of conventional buttress plate.

Methods: We studied 30 patients involving proximal tibial fracture manged using LCP [23 patients with minimally invasive plate osteosynthesis, (MIPO) technique and 7 patients with Open reduction and internal fixation (ORIF) technique]. We followed up all the patients until complete union of fractures.

Results: The average time for union of fracture was 14 weeks (range: 12-24 weeks). Overall 96.7% patients had acceptable outcome (70% excellent and 26.7% good). Patients treated with MIPO technique healed earlier and more frequently had excellent results than those treated with ORIF. A total of four patients had complications (knee joint stiffness in 1, postoperative loss of reduction in 1, infection in 1 and knee instability in 1).

Conclusions: Locking compression plate system acts as a good biological fixation for proximal tibial fractures even in difficult fracture situations. MIPO technique offers faster healing and better outcome than ORIF in patients with proximal tibial fractures.


Proximal tibial fracture, Locking compression plate, Minimally invasive plate osteosynthesis, Open reduction and internal fixation

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