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Volume 1 Issue 3 (July 2012)

Original Articles

Investigating Surgical Approaches in the Management of Tibial Plateau Fractures
Ameet M Rayanagoudar

Background: The primary objective of this study is to examine the surgical approaches employed in treating intra-articular fractures of the proximal tibia, based on an analysis of 64 cases. Additionally, a comprehensive literature review on the management of upper tibial fractures, with a particular focus on surgical interventions, has been provided. Methods: The study encompasses the surgical treatment of tibial plateau fractures, with inclusion criteria comprising patients aged 18 years and above of any gender. The fractures were diagnosed radiologically, and their classification was based on the Schatzker system. Results: Tibial plateau fractures exhibit a slight right-sided predominance at 60%, with 40% occurring on the left side. The primary cause of these fractures is frequently linked to automobile accidents or road traffic incidents. Males are notably more susceptible, accounting for 90.63% of cases compared to 9.37% in females. In our series, the majority of fractures were either pure cleavage (type-I) or a combination of cleavage and depression (type-II). Patients were admitted and underwent surgery within 2 to 5 days, contingent upon factors such as wound status or the general condition of the patient. Each case was approached individually, and postoperative mobilization was initiated as early as the 3rd day in most cases. The duration of joint immobilization significantly influences the ultimate outcome. Rigid internal fixation was deemed essential whenever feasible. Conclusion: In the evolving landscape of closed tibial plateau fractures, minimal invasive procedures such as Minimally Invasive Plate Osteosynthesis (MIPPO) are poised to play an increasingly significant role. This is particularly evident when employing advanced technologies like the Locking Compression Plate (LCP). The adoption of these techniques holds promise for improved outcomes in the future.

 
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