Management of Tibial Plateau Fractures by Minimal Invasive Surgical Procedures – A clinical study
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2016, Vol 4, Issue 3
Abstract
Recently minimally invasive procedures are now gaining popularity in orthopaedic surgeries as they limits soft tissue infection at fracture site and have fewer complications. These procedures reduce morbidity and avoid many of the complications of both conservative and operative treatment and can have faster rehabilitation. The present prospective study was carried out in Department of Orthopaedics, Deendayal Upadhyaya Hospital, and New Delhi between October 2007 to June 2010. The study included 33 patients of tibial plateau fracture. Relevant clinical history was taken and comprehensive physical examination with local examination was done. A thorough radiological evaluation was done by taking X -ray knee including leg AP view, Lateral view, Oblique view (Internal and External), Tibial plateau view (10-15 degree caudally tilted) and Traction view. SCHATZKER‟S classification was used to classify tibial plateau fracture. The patients were treated by pre-operative skeletal traction and minimal soft tissue dissection using minimally invasive methods. Implants used were buttress plates and screws, cancellous cannulated partially threaded screws and Arbeitsgemeinschaft für Osteo synthesefragen (AO) tubular external fixators. Finally, the plate was slide extra periosteally through a very short incision. In results the most common fracture in our series was Schatzker‟s type II fracture (nine patients) followed by type VI (eight patients) followed by type V (six patients).Age range was between 24 to 61 years with majority of patients in 26 to 35 years of age group. All cases with type I and type IV fractures had excellent results. Seven cases (78%) of type II fractures had excellent results and rest 2 cases (22%) had good result. One case of both type V and type VI fracture had fair result. Only one case (3%) in our series of Type VI fracture had poor result. The overall functional end results in the follow up were 66.7% excellent, 23.3% good, 6.7% fair and 3.3% poor. In conclusion the Minimal invasive surgery for tibial pleateau fractures was associated with high rate of success across all categories of Schatzker‟s type fracture. An acceptable functional end result was obtained in 96% of the patients. Keywords: Tibia Fracture; Less invasive; Minimally Invasive Surgery; Schatzker‟S Type Fracture.
Authors and Affiliations
Pradeep Kumar Saini, Lalit Kishore, Anurag Jain, V. K. Goyal, Manoj Gangil, Ranjan Sinha
Keywords
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