Management Of Proximal Tibial Fractures with Different Modalities
Authors/Creators
- 1. Assistant Professor, Department of Orthopedics, Pravara Medical College, Loni.
Description
Background: Fractures of proximal tibia have always been difficult to treat because of the subcutaneous location of its anteromedial surface. These days significant attention has been paid to the condition of soft tissue envelopes. Aims: To evaluate the end results of tibial plateau fractures treated and different modalities of the treatment and their complications in our hospital. Methodology: A prospective study was conducted on 30 patients with proximal tibial fractures at the Orthopaedic Department of MGM Medical College and Hospital, Navi Mumbai. Results: The mean age was 35.2 ± 10.73, and there were more men (70%) than women (30%). According to the radiological Schatzker classification, I fracture (33.3%) and III fractures (23.33%) were the most prevalent among the study population. The next most prevalent were types 2 and 4. Right proximal tibia fracture (66.7%) was the most common diagnosis among the study population, followed by left (33.3%). The study population’s most often used treatment methods were locked plates (33.33%), buttress plates (5%) with bone grafting, and (5% without). The study population’s most frequent early complications were pain (26.7%), limited knee mobility (41.3%), infection (10%), delayed union (51.6%), and malunion (3.3%). 56.7% of the study population had excellent outcomes, 26.7% had good outcomes, fair in 13.3%, and poor outcomes 3.3%. Conclusion: To consistently provide great and positive outcomes, the surgeon needs to have a solid understanding of the type of proximal tibia damage and be conversant with the range of current procedures available for treating these fractures.
Abstract (English)
Background: Fractures of proximal tibia have always been difficult to treat because of the subcutaneous location of its anteromedial surface. These days significant attention has been paid to the condition of soft tissue envelopes. Aims: To evaluate the end results of tibial plateau fractures treated and different modalities of the treatment and their complications in our hospital. Methodology: A prospective study was conducted on 30 patients with proximal tibial fractures at the Orthopaedic Department of MGM Medical College and Hospital, Navi Mumbai. Results: The mean age was 35.2 ± 10.73, and there were more men (70%) than women (30%). According to the radiological Schatzker classification, I fracture (33.3%) and III fractures (23.33%) were the most prevalent among the study population. The next most prevalent were types 2 and 4. Right proximal tibia fracture (66.7%) was the most common diagnosis among the study population, followed by left (33.3%). The study population’s most often used treatment methods were locked plates (33.33%), buttress plates (5%) with bone grafting, and (5% without). The study population’s most frequent early complications were pain (26.7%), limited knee mobility (41.3%), infection (10%), delayed union (51.6%), and malunion (3.3%). 56.7% of the study population had excellent outcomes, 26.7% had good outcomes, fair in 13.3%, and poor outcomes 3.3%. Conclusion: To consistently provide great and positive outcomes, the surgeon needs to have a solid understanding of the type of proximal tibia damage and be conversant with the range of current procedures available for treating these fractures.
Files
IJPCR,Vol16,Issue1,Article226.pdf
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Additional details
Dates
- Accepted
-
2024-01-30
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue1,Article226.pdf
- Development Status
- Active
References
- 1. J. Praneeth Kumar Reddy, B. Shaikh Nazeer, Arun H. S and N. Mahesh Kumar, Study of surgical management of proximal tibial fractures using locking compression plate. International Journal of Biomedical and Advance Research 2016;7(3):123-127. 2. Moore TM, Patzakis MJ, Harvey JP. Tibial plateau fractures: definition, demographics, treatment rationale, and long-term results of closed traction management or operative reduction. J Orthop Trauma.1987; 1:97– 119. [PubMed] 3. Marsh JL, Slongo TF, Agel J, et al. Fracture and dislocation classification compendium – 2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma 2007;21(10): S1–S133. 4. Thomas Nusselt, Alexander Hofmann, Daniel Wachtlin, Stanislav Gorbulev, And Pol Maria Rommens, Cerament Treatment of Fracture Defects (Certify): Protocol for A Prospective, Multicenter, Randomized Study Investigating The Use Of Cerament™ Bone Void Filler In Tibial Plateau Fractures, Trials.2014;15:75. 5. Tscherne H, Lobenhoffer P. Tibial plateau fractures. Management and expected results. Clin Orthop Relat Res. 1993;(292):87–100. 6. Cole P, Levy B, Schatzker J, Watson JT. Tibial plateau fractures. In: Browner B, Levine A, Jupiter J, Trafton P, Krettek C, editors. Skeletal Trauma: Basic Science Management and Reconstruction. Philadelphia, PA: Saunders Elsevier.2009:2201–87. 7. Musahl V., Tarkin I., Kobbe P., New trends and techniques in open reduction and internal fixation of fractures of the tibial plateau J Bone Joint Surg.2009;91-B: 426-33. 8. Raikin S. Froimson MI. Combined limited internal fixation with circular frame external fixation of intraarticular tibial fractures; Orthopedics. 1999 Nov; 22(11):1019-25. 9. Kulwinder Singh, Dr. Manjeet Singh, Dr. Rakesh Gautam, Functional Outcome of Surgical Management of Tibial Plateau Fractures: Case Series of 30 Cases, International Journal of Science and Research.2015;4(9):905-09. 10. Lee JA, Papadakis SA, Moon C and Zalavras CG. Tibial plateau fractures treated with theless invasive stabilisation system. Int Orthop. 2007 June; 31(3): 415–18. 11. Albuquerque, RP e, Hara R, Prado J, Schiavo L, Giordano V, & Amaral NP do. Epidemiological study on tibial plateau fractures at a level I trauma center. Acta Ortopédica Brasileira. 2013;21(2):109-15. 12. Manidakis N, Dosani A, Dimitriou R, Stengel D, Matthews S, and Giannoudis P. Tibial plateau fractures: functional outcome and incidence of osteoarthritis in 125 cases. Int Orthop. 2010 April; 34(4): 565–70. 13. Mehin R, O'Brien P, Broekhuyse H, Blachut P, Guy P. Endstage arthritis following tibia plateau fractures: average 10-year follow-up. Can J Surg. 2012 Apr;55(2):87-94. 14. Dr. C.V. Dasaraiah, Dr. Addepalli Srinivasa Rao, Dr. T. Anilkumar, Study of Surgical Management of Tibial Plateau Fractures – Functional and Radiological Evaluation IOSR Journal of Dental and Medical Sciences (IOSR-JDMS). Jan. 2016; 15(1):18-27. 15. Sahu Ramji Lal, Rajni Ranjan, comparative study of fixation of tibia plateau fractures by nonlocking buttress versus locking compression plate International Journal of Orthopaedics Traumatology & Surgical Sciences, December-May 2016;2(1):110-118. 16. Girish H. Vasanad, S.M. Antin, R.C. Akkimaradi, Prasad Policepatil, Girish. Naikawadi. Surgical Management of Tibial Plateau Fractures – A Clinical Study, Journal of Clinical and Diagnostic Research. 2013 Dec;7(12): 3128-3130. 17. Sharma C, Sharma A, Kalla R, Study of various treatment modalities and functional outcome for tibial plateau fractures, IJRRMS 2013;3(3):27-30.