Study on efficiency of locking compression plate for fracture of upper end of tibia
Abstract
Background: Fractures of proximal end tibia have historically been difficult to treat because of its subcutaneous location of the anteromedial surface of the tibia. Locking compression plate device offers potential biomechanical advantage over other methods. Locking compression plate has added advantage of the ability to manipulate and reduce the small and often osteoporotic fracture fragments directly. The present study objective was to compare the efficiency of locking compression plate in treatment of fractures with other standard methods of treatment.
Method: In the present study, 20 patients with closed fracture of upper end of tibia were studied. All the cases were treated at GSL General Hospital, between 2015 & 2017 and followed for a minimum of 6 months.The method used for fracture fixation was closed or open reduction and internal fixation with locking compression plate. The duration of follow up was 6 months.
Result: In the present study the commonest mode of injury being the road traffic accident 90%. There was Left sided predominance, compared to the right side. Most of the patients fall into type III, type IV, type V and type VI schatzker’s classification. 14 (70%) patients showed excellent result and 5 (25%) patients showed good outcome.
Conclusion: Locking Compression Plate is an important armamentarium in treatment of fractures around knee especially when fracture is severely comminuted and in situations of osteoporosis.
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References
2. Charles .M. Court –Brown, In: Fractures of tibia and fibula chapter 52, Rockwood and Green’s “Fractures in Adults”, Vol. 2, 6th edition, Lippincott Williams and Wilkins, 2010.
3. Cole PA, Zlowodzke M, Kregor PJ. Treatment of proximal tibial fractures using the Less Invasive Stabilisation System: Surgical Experience And Early Clinical results in 77 fractures. J OrthopaedTrauma. 2004; 18(8):528-535.
4. Egol KA, Su E, Tejwani NC, Sims SH, Kummer FJ, Koval KJ. Treatment of complex tibial plateau fractures using the less invasive stabilization system plate: clinical experience and a laboratory comparison with double plating. J Trauma Injury Infect Critical Care. 2004;52(2): 340-346.doi: 10.1097/01.TA.0000112326. 09272.13
5. Sommer C, Wullschleger M, Walliser M, Bereiter H, Leutenegger A. Experience with the locking compression plate (LCP) in fracture treatment of osteoporotic bone. British J Surg. 2004;91(7):912.
6. Girisha BA, Rajesh P, Kumar SC, Muralidhar N. Surgical management of proximal tibial fractures with locking compression plate. Int J Res Orthop 2017;3(4): 756-60.doi: http://dx.doi.org/10.18203/issn.2455-4510. Int JRes Orthop20172549
7. Stannard JP, Wilson TC, Volgas DA, Alonso JE. Fracture stabilization of proximal tibial fractures with the proximal tibial LISS: early experience in Birmingham, Alabama (USA). Injury. 2003;34(1):A36-42.doi: https://doi.org/10.1016/S0020-1383(03)00256-0
8. Rasmussen PS. Tibial condylar fractures: impairment of knee joint function as an indication for surgical treatment. J Bone Joint Surg Am. 1973;55(7):1331-50.
9. Honkonen SE. Indications for surgical treatment of tibial condyle fractures, Clin Orthopaed. 1994;302;199-205.
10. Gosling T, Schandelmaier P, Muller M, Hankemeier S, Wagner M, Krettek C. Single lateral locked screw plating of bicondylar tibial plateau fractures. Clinic Orthopaed Related Res. 2005; 439:207-14.
11. Ahmad M, Nanda R, Bajwa AS, Candal-Couto J, Green S, Hui AC. Biomechanical testing of the locking compression plate: when does the distance between bone and implant significantly reduce construct stability?Injury.2007;38(3):358–364.doi: https:// doi.org / 10. 1016/j.injury.2006.08.058
12. Kenneth A. Egol and Kenneth J Koval, In: Fractures of proximal tibia: chapter 50, Rockwood and Green’s “Fractures in Adults”, Vol. 2, 6th edition, Lippincott Williams and Wilkins 2006.
13. Oh CW, Oh JK, Min WK, Jeon IH, Kyung HS, Ahn HS, et al. Management of ipsilateral femoral and tibial fractures. Int Orthopaed. 2005;29(4):245-50.doi: 10. 1007/ s00264-005-0661-7
14. Phisitkul P, McKinley TO,Nepola JV, Marsh JL. Complications of Locking plate fixation in complex proximal tibia injuries. J Orthop Trauma. 2007;21 (2): 83-91.doi: 10.1097/BOT.0b013e318030df96
15. Jain R Prospective case dtudy of outcome of tibial plateau fractures treated with Locking Compression plate.Malays Orthop J. 2016;10(3):12–16.doi: 10.5704/ MOJ.1611.007
16. Delamarter RB, Hohl M, Hopp JE. Ligament injuries associated with tibial plateau fractures. ClinicOrthopaed Related Res. 1990(250):226-33.