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Prospective Evaluation of Functional Outcomes in Schatzker Type V-VI Proximal Tibia Fractures Managed with Locking
Mayank Uikey1, Vishal Singh2, Harshit Dahiya3
1Department of Orthopaedics, GMC, Ratlam, Madhya Pradesh, India.
Introduction:
Proximal tibial fractures, especially Schatzker type V and VI injuries, are complex bicondylar fractures usually associated with severe soft tissue damage and significant functional morbidity. Managing these fractures remains challenging. Locking compression plate fixation using the minimally invasive percutaneous plate osteosynthesis (MIPPO) technique has gained popularity because it preserves the biology at the fracture site, minimizes soft tissue disruptions, and provides stable fixation.
Materials And Methods:
This prospective study was conducted in the Department of Orthopaedics at Gajra Raja Medical College and JAH Hospital from May 2023 to October 2024, over a period of 18 months. A total of 40 patients with proximal tibial fractures, Schatzker type V and VI, were included in this study. This study was conducted to evaluate the functional outcome of proximal tibial fractures of Schatzker type V and VI managed with locking compression plate fixation by the MIPPO technique. Patients with closed proximal tibial fractures and selected open fractures fulfilling the inclusion criteria were treated surgically and followed up at 1 month and 3 months. Functional outcomes were assessed clinically using the Modified Rasmussen scoring system. Standard criteria, including range of motion, fracture union, complications, and knee function scoring at the final follow-up, were used.
Results:
Most fractures achieved satisfactory union within an acceptable period. Functional outcomes were good to excellent in the majority of the patients, with restoration of knee movement and stable fracture fixation. The results demonstrate statistically significant improvements in functional scores at both time points. At 1 month, the mean score was 10.20 (t = 10.743, df = 39, P < 0.001), with a 95% confidence interval of 8.28-12.12, indicating a fair level of knee function according to the Modified Rasmussen scale. At 3 months, the mean score markedly increased to 26.90 (t = 81.583, df = 39, P < 0.001), with a 95% confidence interval of 26.23 to 27.57, reflecting a good to excellent functional outcome.
Conclusion:
Locking compression plate fixation using the MIPPO technique is an effective method for managing Schatzker type V and VI proximal tibial fractures. It provides stable fixation, promotes fracture union, preserves soft tissue integrity, and results in favorable functional outcomes when proper surgical technique and rehabilitation are followed.