A study on surgical management of closed tibial condylar fractures in adults

Abstract

Backfround: Tibial plateau fractures are one of the commonest intra-articular fractures. It results from indirect coronal or direct axial compressive forces. It comprises of 1% of all fractures. Being one of the major weight bearing joints of the body, fractures around it will be of paramountimportance. Methods: 30 cases of tibial plateau fractures treated by various modalities were studied from September 2017 to september 2019 at our institution and followed for minimum of 6 months. Results: The selected patients evaluated thoroughly clinically and radiologically, after the relevant lab investigations, were taken for surgery. The indicated fractures treated as per the SCHATZKER’S types, accordingly with CRIF with percutaneous cannulated cancellous screws, MIPPO with LCP/ Butress plate and screw, ORIF with buttress plate/ LCP and screw. Early range of motion started soon after the surgery. No weight bearing upto 6 weeks. The full weight bearing deferred until 12 weeks or complete fracture union. Immobilization in insecurely 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. Infection in two cases and stiffness in 2 cases were seen and there was no non-union in our cases.Conclusion: Surgical management of tibial condylar fractures will give excellent anatomical reduction and rigid fixation to restore articular congruity, facilitate early motion , hence to achieve optimal knee function and reducing post-traumatic osteo arthritis.

Keywords: Fracture, tibial condyle, buttress plate, locking compression plate, MIPPO.