Title: Complicated Tibial Plateau Fractures in Young Patients: Functional Outcome with Dual Plating via 2Â¬Incision Technique
Dr. Qadir is a self-driven, motivated person. He have always been an academically bright. He have capability to work under extremely stressful conditions. Being qualified in Clinical sciences, he is used to working long and hard hours, around the clock. In fact, his work keeps the fires burning for him. Learning human nature is one of his other interests. Nature of every human being is so unpredictable and diverse; studying, how different persons respond under various circumstances, is what he really love.
Objective: Motorbike accidents contribute one of the most important factors of tibial plateau fracture among young populations in Karachi Pakistan. This prospective study was designed to evaluate the functional outcomes of dual plating via a 2incisions technique for the fixation of complicated bicondylar tibial plateau fractures in young patients in Karachi pakistan. Method:This prospective study include 94 cases of Type V and VI tibial plateau fractures of young patients age range from 15-45 years, operated between January 2014 and Dec 2016 conducted in two public sector hospital of Karachi Pakistan (Jinnah Post Graduate Medical Center, Civil Hospital Karachi). Exclusion criteria include patients with multiple fracture on same side or same bone, age more than 45 years, open contaminated fracture, open fracture and patients with head injuries. All cases were operated either by lateral locking plate fixation by anterolateral approach or dual plating through double incisions. Results:A total of 94 patients (45 Single Plating and 49 Dual Plating) were operated during the study period of two years.Both groups were somewhat similar in relation to the age, mechanism of injury, fracture pattern and soft tissue injury.Postoperatively,there was no immediate difference in between the groups considering the malalignment and reduction. It took approximately 4 to 5 months for the fractures to get united.A total of 38 (77%) patients in a double plating group regained full flexion (135°) and full extension (0°) with a good alignment and no pain and instability as compaired to single plating group, seen in 30 (66%) patients at follow-up. Conclusion: Dual plating by two incision method resulted in better functional outcome regarding limb alignment and range of movements at knee joint with an acceptable soft tissue complication rate in young patients.
Key Words: Complicated Tibial plateau fracture, young patients, double incision, dual plating