Anudeep N Naik

Abstract

Background: Tibial condylar fractures are very common in road traffic accidents; however, sports injury, fall and other trivial trauma can frequently produce these fractures. These are unstable fractures and quite challenging to manage. This study was undertaken to evaluate locking compression plate (LCP) fixation in proximal intra articular tibia fractures by MIPPO (minimally invasive percutaneous plate osteosynthesis) technique. Materials and Methods: The study was conducted from 0ctober 2016 to 2018. 20 cases who had sustained tibial plateau fractures (Schatzker type 1- VI) and operated with LCP fixation using MIPPO technique were included in this study after obtaining informed consent. Follow-up was done at 6 weeks, 12 weeks, 18 weeks and 24 weeks after the surgery and they were evaluated in accordance with modified Rasmussen knee scoring system. Results: Modified Rasmussen functional knee scoring system and modified Rasmussen criteria for radiological assessment was used to analyse the functional outcome among the cases. After evaluation it was observed that 90% of the patients had good to excellent performance. Conclusion: MIPPO technique enables soft tissue stripping via a small surgical incision and provides a rigid fracture reduction. There is also a reduced chance of post traumatic soft tissue injury. Proximal Tibial locking plate is a good device to stabilize the fractures of Tibial plateau (intra articular), especially when used in conjunction with meticulous intraoperative handling of the soft tissues and active participation of the patients in the rehabilitation programme is ensured. Keywords: Proximal tibia, MIPPO, Intra – articular, Tibia plateau, Locking compression plate.

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Abstract

Most calcaneal fractures are intraarticular fractures involving the posterior facet of the subtalar joint. Treating displaced intraarticular calcaneal fractures is challenging due to the paucity in optimal treatment options. Internal fixation typically involves screw-and-plate implants, which can be unfavourable owing to the lack of an anatomic design and the intraoperative bending required for the plate to contour to the irregular surface of the calcaneus. In our study we included fifteen patients, two were female and the rest thirteen were male. The mechanism of injury involved road traffic accident in two cases and fracture as a result of fall from height in the remaining patients. These patients were followed up for 6 months at the end of which functional outcome was assessed in all patients using the Ankle-Hind foot scale, that included assessment of pain, function, maximum walking distance, gait abnormality, graded difficulty in walking on different surfaces, motion, stability of ankle and alignment of ankle and foot. Based on this scale 10 patients (66.6%) had good outcome, 4 patients had fair outcome (26.6%) while 1 patient (6.66%) had poor outcome. The results were promising, revealing that the anatomic locking plate can be used effectively in the treatment of displaced intraarticular calcaneal fractures using simple reduction techniques with a potentially shortened operating time. Keywords: Calcaneum.

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