"Surgical management of tibial plateau fractures - a clinical study"
Girish H Vasanad1, S M Antin2, R C Akkimaradi2
1Assistant Professor, Department of Orthopaedics, S.N. Medical College , Bagalkot-587103, Karnataka, India .
Background:
Advance in mechanization and acceleration of travel have been accompanied by increase in number and severity of fractures and those of tibial plateau are no exception. Being one of the major weight bearing joints of the body, fractures around it are of paramount importance. The study was aimed to identify the role of surgical treatment of tibial plateau fractures, its functional outcome and complications.
Methods:
Thirty-two cases of tibial plateau fractures treated by various modalities were studied from Jan 2004 to Dec 2005 at Bapuji Hospital and Chigateri General Hospital, Davangere and followed for minimum period of 6 months.
Results:
The selected patients evaluated thoroughly: clinically and radiologically, were taken for surgery, after the relevant lab investigations. The indicated fractures were treated as per the SCHATZKER'S types accordingly with CRIF, with percutaneous cannulated cancellous screws, ORIF with buttress plate with or without bone grafting, external fixator. Early range of motion started soon after the surgery. No weight bearing upto 6-8 weeks. The full weight bearing deferred until 12 weeks or complete fracture union. Immobilization in insecurily fixed fractures continued for 3-6 weeks by POP cast. The knee range of motion was excellent to very good, gait and weight bearing after complete union was satisfactory. redepression in 1 case, malunion in 2 cases, knee stiffness in 3, wound dehiscence in 2 cases and non-union in none of our cases.
Conclusion:
Surgical management of tibial plateau fractures will give excellent anatomical reduction and rigid fixation to restore articular congruity, fascilitate early motion and reducing post-traumatic OA and hence to achieve optimal knee function.
