A Society of Orthopaedics, Surgical and Dental Sciences
International Journal of Orthopaedics Traumatology & Surgical Sciences
Year: 2019, Volume: 5, Issue: 1, Pages: 188-191
Pradeep Kumar Tiwari1 , Sandeep Kumar2 , D.R. Galfat3 , Surabhi Vyas4
1 - M.S. Ortho, Post Graduate Medical Officer (Orthopedics), Trauma Center, G.R. Medical College, Gwalior (MP)
2 - Professor Department of Orthopedics Hamdard Institute of Medical Science & Research, New Delhi
3 - Professor Department of Orthopedics & Director Academics Pacific Institute of Medical Science, Udaipur
4 - Associate Professor Department of Radio Diagnosis, AIIMS, New Delhi
Aim:- Aim of this study is to assess the outcome after open reduction and internal fixation using a periarticular raft plating with screw fixation without bone grafting for split – depression tibial plateau fractures.
Methods:- 15 patients with 15 knees in 10 male and 5 female were managed by open reduction & internal fixation with, raft locking plate with raft screws through plate without use of bone graft or bone substitute for split depression fracture (> 5 mm.). Proximal tibial fractures (Schatzker type II or Ao / OTA type 4.1 B3) were treated and the result were assessed by radiographs & clinical examination. The Rasmussen radiological score & clinical score, the Lysholm knee score, and the Tegner activity score were also assessed. Result:- The mean follow was 12.5 (rang, 6 -19) months. All patients achieved bone union after a mean of 12.4 (range 8 -24) weaks. The mean range of motion was 116 degree (100o – 130 o). The Rasmussen radiological score was excellent in 10 patients, good in 4, and fair in 1. The Rasmussen clinical score was excellent in 8, good in 6, and fair in 1 patient. The Lysholm was excellent in 9 patients, good in 4, and fair in 2. 13 out of 15 patients recovered to their pre operative Tegner activity scores. Only 1 patients having severe communition had loss of reduction after full weight bearing.
Conclusion:- Internal fixation using a periarticular raft locking compression plate without using a bone graft or bone substitute for split depression proximal tibial plateau fractures is a viable option.
Keywords: bone graft, raft plate & screws, internal fixation
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