A study on functional outcome of communited tibial plateau fractures treated by modified frosch lobenhoffer approach

Abstract

Background: When dealing with complex tibial plateau fractures, trauma surgeons face a significant challenge. Good articular reduction preserves congruity by lowering long-term complications. It has the potential to prevent or postpone the onset of post-traumatic osteoarthritis. It is well known that achieving the best possible articular congruity after a tibial plateau (TP) fracture is associated with long-term functional outcomes. Reduction in complex tibial plateau fractures is difficult, especially in the posterior segments of the lateral TP; impaired visualisation of this part of the articular surface through standard surgical approaches is the most important risk factor for mal reduction. Objectives: To study the functional outcome of complex tibial plateau fracture with different surgical approaches for proximal tibial plateau fractures. Design: A prospective study. Study site: At SVRRGG hospital Tirupati. Methods: This is a prospective study carried out in Department of orthopedics, S.V.R.R.G.G. Hospital, Sri Venkateswara Medical College, Tirupati. All patients with tibial plateau fracture which are admitted into hospital were evaluated. Cases satisfying inclusion and exclusion criteria were included into study. tibial plateau fractures were treated surgically by (using Locking Compression Plate, Buttress plates) via modified Frosch, Loben Hoffer approaches at our institution. The patients were evaluated clinically and radiologically for outcomes. Knee society score was used for evaluation at 3, 6 and 12 months respectively. All patients were followed up for an average of 12 months. Observation and Results: Average age of patient in our study was 34.6 years. There were 15 male and 9 female patients. 15 patients had fracture on right side while 9 patients had it on left. There were 20, 4 patients with schatzker type 5 and 6 respectively. We used Frosch approach in 8 patients while remaining had Loben Hoffer approach. Knee Society score was 65, 76 and 89 at 3, 6, and 12 months respectively. Conclusion: We recommend Frosch and Galla Loben-Hoffer approaches for proper reduction, fixation, and better functional outcome of posterior proximal tibial fractures.