Proximal tibial fractures: early experience using polyaxial locking-plate technology.

Area of Science:

• Orthopaedic Surgery
• Trauma Management
• Biomedical Engineering

Background:

• Proximal tibial fractures present complex challenges in achieving stable fixation and optimal functional recovery.
• Traditional fixation methods may have limitations in addressing the diverse fracture patterns and anatomical complexities of the proximal tibia.

Purpose of the Study:

• To evaluate the efficacy and safety of a polyaxial locked-plate fixation system in treating proximal tibial fractures.
• To assess functional outcomes, union rates, and complication profiles associated with this fixation system.

Main Methods:

• A prospective study involving 60 patients with proximal tibial fractures treated with a polyaxial locked-plate system.
• Clinical and radiographic data, including fracture classification (OTA 41-A, B, C), fixation techniques, complications, and union, were analyzed.
• Follow-up averaged 14 months, assessing alignment, hardware integrity, and functional scores (Knee Society Score).

Main Results:

• High fracture union rate (all but three fractures) at a mean of 3.2 months.
• No instances of varus collapse due to screw failure, plate fracture, or screw cutout were observed.
• Excellent functional outcomes with a mean Knee Society Score of 91 and a mean functional score of 89 were reported.
• A low complication rate was noted, with one case of lateral joint collapse in a complex fracture pattern.

Conclusions:

• The polyaxial locking-plate system offers stable fixation for both extra-articular and intra-articular proximal tibial fractures.
• This system facilitates good functional recovery and demonstrates a low complication rate in the management of these injuries.