Surgical outcome of tibial plateau fracture using minimally invasive technique with locking compression plate

Abstract

Introduction:The following study was conducted to examine the short term clinical and radiological results particularly early complications and healing rate of tibial plateau fractures treated with LCP by minimally invasive technique. Methodology: The study was conducted in patients treated for tibial plateau fractures (type 1 to 4 Schatzker classification) at Adhichunchangiri Institute of Medical Science, BG Nagar from the month of May 2011 to May 2016. Fifty tibial plateau fracture patients were taken into the study, all were fixed with LCP using minimally invasive technique. Patients' age ranged from 20 to 70 years with a mean of 45. Results: The sample consisted of twenty patients with 38 males and 12 were females. The patients' ages ranged from 20-70 years with a mean age of 45 years. The causes of fractures were motorvehicle accident in 36 patients and fall in 14 patients. There were no sports or industrial accidents. 31 fractures involved the right side and 19 involved the left. The average length of hospitalisation was 12 days with a range of 7 to 20 days. The average number of days from injury to surgery was 5 days with a range of 2 to 10 days. The operative time ranged from 45 minutes to 100 minutes. Patients were followed up from 01 to 24 months. Functional outcome was rated as per NEER'S RATING SCORE, we got excellent results in 24 cases, good in 15, fair in 08 and poor in 03 patients. Conclusion: Treatment of tibial plateau fractures using LCP provides good results. Since we have used minimally invasive technique soft tissue damage is minimal thus promoting good healing of fracture and less infection rates. Our early results were encouraging but long term studies are needed to prove definitively acceptable outcomes so that the technique can become part of the in the armamentarium of the orthopaedic trauma surgeon. Keywords: Tibial plateau fracture, Schatzker classification, Minimally invasive technique, Locking Compression Plate, NEER'S Rating Score IntroductionTibial plateau fractures are on a raise due to increased incidence of road traffic accidents and also at the same time the surgical management for the same are also being modified continuously [1] . The luxuries of our life in the present time is at the cost of rapidly increasing industrialization, urbanization and mechanisation -so also the traumatic cases are on increase. Crowded cities, irregular traffic arrangement, fast moving vehicles are the most important contributory factors causing bony injuries, particularly polytrauma, comminuted fractures and also the soft tissue injury [2] . Tibial plateau fracture is one of them. Tibial plateau fractures have been studied and reported extensively and exhaustively but still controversy exists over its management, whether surgical or conservative. Even undisplaced tibial plateau fractures should be operated, so that early mobilization of knee is possible [1] .