Assessment of functional outcome of lower third tibial fracture fixation with distal tibial locking plate: An observational study

Abstract

Background: Fractures of the distal third shaft and distal metaphysis of tibia are one of the difficult and challenging problems faced by orthopaedic surgeons. These fractures are usually associated with fractures of the lower third of fibula which need to be addressed separately to get well aligned ankle mortis, unlike the proximal and mid third shafts fractures of tibia, where fibular fractures need not always be treated separately. Hence; the present study was planned for assessing the functional outcome of lower third tibial fracture fixation with distal tibial locking plate. Materials & methods: A total of 30 patients with lower third tibial fractures were enrolled. Pre-operative clinical and radiographic examination of all the patients was carried out. Patients were prepared for locking plate fixation and pre-anaesthetic preparation was done. All the orthopaedic procedures of locking plate fixation were carried out under the hands of skilled and experienced orthopaedic surgeons. Follow-up was done and functional outcome was assessed on follow-up. Olerud-Molander functional evaluation score (OMFES) was used for evaluating the functional outcome on final follow-up. Complications, if any, were recorded separately. Results: According to OMFES, while assessing the functional outcome, it was observed that excellent results were present in 20 percent of the cases while good results were present in 70 percent of the cases. Fair results were found to be present in 10 percent of the cases. Complications were found to be present in 23.33 percent of the cases. Malunion was found to be present in 1 case, while non-union was found to be present in 2 cases. Superficial infection was found to be present in 13.33 percent of the cases. Conclusion: Even though distal locking plates are associated with good functional outcome, significant proportion of the patients show occurrence of postoperative complications. Hence; proper care should be while performing these orthopedic procedures for reducing complication rate.