Online ISSN: 2515-8260

Functional Outcome of Intra Articular Proximal Tibial Fractures Associated with Ligament Injury Treated with Locking Compression Plating

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1. Dr. Ankit Barosani,2. Dr. Anurag Anand3. Dr.D.S. Bhamare4. Dr. Shubham Taori5. Dr. Somireddy Medapati

Abstract

The goal of this study was to assess the incidence of soft tissue injury in operative tibial plateau fractures by clinical examination, stress radiography and to understand the ligament injury pattern associated with these fractures according to Schatzker’s classification. A total of 50 patients who were operated for tibial plateau fracture were included in this study. Soft tissue injuries like meniscus, anterior/posterior cruciate ligaments and medial/lateral collateral ligaments injuries were assessed by clinical examination and were confirmed on stress radiography. The total incidence of soft tissue injury in our study was 58%. The rates of soft tissue injury in types IV and II (respectively, 80 and 38 %) were higher than those in other types. The meniscus injury was the most common soft tissue damage, with the incidence of meniscus injury was 26%. None of the patients in our study had a pre-operative MRI done and thereby none were preoperatively diagnosed with any soft tissue injury. The functional outcome of these patients was assessed using standard knee scores. Tibial plateau fractures frequently have important soft tissue injuries that are difficult to diagnose on physical examination. A significantly higher incidence of ligament injury is seen in high-energy fracture patterns (Schatzker type IV, V, VI) and a careful evaluation to rule out a spontaneously reduced knee dislocation is important in such patients. We believe MRI scanning should be considered for tibial plateau fractures due to high-energy mechanism, allowing identification and treatment of associated soft tissue injuries.

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