STUDY OF OUTCOME OF POSTERIOR PLATING IN TIBIAL PLATEAU FRACTURE WITH POSTEROMEDIAL APEX BY DIRECT POSTERIOR APPROACH

Dr G N PUNDKAR; Dr U R DESHMUKH; Dr R W. BAITULE; Dr Chinmay Sangole; Dr Suraj Singh; Dr Sankalp Makarande

Volume : VIII, Issue : VII, July - 2019

STUDY OF OUTCOME OF POSTERIOR PLATING IN TIBIAL PLATEAU FRACTURE WITH POSTEROMEDIAL APEX BY DIRECT POSTERIOR APPROACH

Dr G N Pundkar, Dr U R Deshmukh, Dr R W. Baitule, Dr Chinmay Sangole, Dr Suraj Singh, Dr Sankalp Makarande

Abstract :

Purpsose –Tibial plateau fractures, one of the commonest intra articular fractures, are major traumatic injuries occurring as a result of RTA, fall from height. The management of tibial plateau fracture has always been a subject of debate because of their variety and complexity. Any fracture around the joint (especially weight beå knee joint in the lower limb) is of paramount importance as it would result in significant morbidity and quality of life may be affected. High energy intraarticular fractures of the tibial plateau cause on going management problems and remains challenging for orthopedic surgeons even todate. Methods–Total 60 cases were included in the study.and We compare our study of posterior plating in tibial plateau fracture with posteromedial apex with 1 indian and 4 foregin author in terms of age, sex ratio, average time for surgey , average time for union, average time for partial and full weight beå , range of motion on day 2 ,6 week,3month and 6 month,fracture classification , infection, non union, varus malunion, nerve injury,. And functional outcome with lyshlom knee score at tertiary care center. Results– This study achieved excellent results in 34 patients ,good in 13 patients,fair in 12 patients,poor in 1 patients evaluated as per the criteria suggested by lyshlom knee score. in this study , 7 pts had SSI and 1 Patient had loss of reduction with no other evidence of varus deformity or deep infections. Our case series attributes to 78% of excellent to good results and 20% of fair 2%of poor results. Conclusion–1.The main aim of surgical treatment include precise reconstruction of articular surface, stable fixation which allows early mobilization of knee which prevents knee stiffness and arthritis. 2.Direct posterior approach to knee gives better visualization of fragment which allows placement of T plate in buttress mode on apex of posteromedial fragment. 3.Fixing the fragment avoids late varus malunion of knee and maintain the knee biomechanics. 4.Non weight bearning knee mobilization on day 2 allows patients early rehabilitation of knee and preventing knee stiffness and gaining functional range of motion.