A STUDY OF SURGICAL MANAGEMENT OF PROXIMAL TIBIA FRACTURES TREATED WITH LOCKING COMPRESSION PLATE

Introduction: Tibial plateau is one of the most critical load bearing areas in the human body. Fractures of tibial plateau affects knee alignment , stability and motion. Incidence of proximal tibia fractures is increasing due to increasing incidence of road traffic accidents. The recent development of locking compression plate (LCP) has revolutionized the treatment of proximal tibia fractures by overcoming the drawbacks of conventional buttress plate.The aim of the study is to evaluate the functional outcome of proximal tibial fractures fixed with locking compression plate. Materials and Methods: This study is 15 patients involving proximal tibia fracture managed using LCP [10 patients with minimally invasive plate osteo-synthesis, (MIPO) technique and 5 patients with Open reduction and internal fixation (ORIF) technique]. We followed up all the patients until complete union of fractures. Results: The average time for union of fracture was 16 weeks (range: 12-24 weeks). Overall 80% patients had acceptable outcome. Patients treated with MIPO technique healed earlier and more frequently had excellent results than those treated with ORIF. A total of three patients had complications (knee joint stiffness in 1, postoperative loss of reduction in 1 and infection in 1). Conclusion: Locking compression plate system acts as a good biological fixation for proximal tibia fractures even in difficult fracture situations. MIPO technique offers short duration of procedure, less blood loss, less soft tissue injury and wound healing was better and faster healing, and better clinical outcome than ORIF in patients with proximal tibia fracture. However MIPO demands more surgical techniques.