Vol. 10, Issue 3 (2024)
Assessment of the outcome of locking compression plate treated fractures of distal tibia
Dr. Sharath Raj, Dr. Vijay Goni, Dr. Tharun Teja Aduri, Dr. Shrinivas VB and Dr. Manoj Kumar
Owing to the scarcity of soft tissue, subcutaneous position, and inadequate vascularity, treating distal tibia fractures surgically presents a significant difficulty for orthopaedic surgeons. There are also a lot of treatment-related problems. There are numerous fixing possibilities. In recent times, the locking plate has emerged as an implant that surgeons find advantageous for treating intricate fractures in the distal region of the tibia. Through the head of locking screws, locking plates provide fixed angular stability and possess the qualities of both internal and external fixators.
Aim: The purpose of this prospective study was to assess the results of plate osteosynthesis using a fixed-angle pre-contoured distal medial tibial locking plate (LCP) as a method of treating juxta-articular and intra-articular fractures of the distal tibia.
Materials and Methods: This study was performed at the Department of Orthopaedic Surgery, Post Graduate Institute of Medical Education and Research Chandigarh India. Fractures in skeletally mature patients involving the distal metaphysis of the tibia requiring stability in the sagittal or coronal plane with or without intra-articular extension were studied. From May 2019 to August 2021, A total of 26 Participants were included in the study. The age distribution of the participants showed that 8 (30.8%) participants were aged between below 30 years. The proportion of participants between 31-40 years and 41-50 years was 30.8% and 15.4% respectively and the proportion of participants above 51 years was 23.1%. Males constituted 65.4% and females constituted 34.6% of the study subjects.
Results: All fractures united within 6 months of time. There were no cases of malunion or non-union. All fractures healed with satisfactory alignment. There were 3 postoperative complications. At 12 months follow-up, we had 17 excellent, 7 good and 2 fairs result. The limitations in this study were, a small sample size and a short follow-up of one year.
Conclusion: In conclusion, with the correct timing of surgery (Wrinkle sign), correct surgical technique and reduction of fracture with an image intensifier, anatomically pre-contoured mono axial fixed angle locking plates and locking screws, is a suitable option for distal tibial fractures. It has better functional outcomes and faster healing rates. The complications of wound infection are less.
Clinical significance: The study evaluates the effectiveness of locking compression plates (LCP) in the surgical treatment of distal tibia fractures, particularly in skeletally mature patients. It highlights the importance of LCPs in facilitating effective healing, reducing complications, and promoting functional recovery. The study also provides insights into complication rates and the Merchant and Dietz scoring system [10] for evaluating functional outcomes. The findings can inform orthopedic surgeons, potentially influencing surgical decision-making and treatment protocols. However, further research is needed to assess long-term outcomes and post-traumatic arthritis risk. The study contributes to improved surgical practices and patient care.
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