Functional outcome and duration of union in proximal Tibial fractures treated with locking compression plate

Abstract

Introduction: Proximal tibial fractures are one of the commonest intra-articular fractures. The various clinical studies established that bone beneath a rigid conventional plate is thin and atrophic which are prone for secondary displacement due to insufficient buttressing and secondary fractures after removal of plate, fracture site take longer period to osteosynthesis due to interruption of vascular supply to bone due to soft tissue and periosteal stripping. Aims and objectives: To treat proximal tibial fractures with locking compression plate in adults. To evaluate the functional outcome and radiological union time in proximal tibial fractures treated with locking compression plate. Method and Materials: 26 patients were selected of age group 18-70 yrs presenting with fracture of proximal tibia on the basis of OPD and emergency admissions in M.B. Govt Hospital Udaipur. Fractures were classified as per schatzker classification. All patients were treated operatively with locking compression plating and its outcomes were assesed using Rassmussens scoring and complications were observed with follow up to 6 months clinically and radiological imaging. Result: Out of 26 cases 21 patients were treated by ORIF and 5 patients were treated by MIPPO, 84, 6% cases were male and 15.4% cases were female. Mean duration of union was 18.46 weeks. Most patients had good range of motion of 130⁰. Most patients had no complications, joint stiffness and infection found in some cases. The final outcome of the fracture most patients had excellent results (13 patients). Conclusion: In our study we found that proximal tibial locking plate provides complete union and early mobilisation to attain better functional outcome. Even in osteoporotic bone, bone graft is not essential for defect in metaphyseal region as LCP internal fixator system act as single implant and prevent collapse of fracture intraoperatively and postoperatively subsequently bone deficient will heal by callus formation.