Özet:

Aim: The main aim of the present study to observe the surgical management of intra articular fractures of the proximal tibia in 32cases.A review of the literature of the management of upper tibial fractures with special reference to surgical management has been presented. Methodology: The surgical management of tibial plateau fractures were included from inpatients of Mahatma Gandhi Memorial Hospital, Warangal. Patients above 18 years of either sex included in the study. Radiological diagnosis of fractures with classification based on Schatzker's classification. Results: Tibial plateau fractures has a slight predominance of right side over left side i.e. 60% and 40%respectively. Automobile accidents or road traffic accidents appeared the commonest cause of tibial plateau fractures. Males are more prone for tibial plateau fractures, i.e. 90.63% in contrast to females9.37%. Majority of the fractures were pure cleavage (type-I) and cleavage combine with depression (type-II) fractures, in our series. The patients were admitted and operated within 2 or 5 days, or depending upon the wound status or general condition of the patient. Each case is individualized and treated. All operated patients were mobilized postoperatively as soon as possible, mostly on the 3rd postoperative day. Period of joint immobilization plays a major role in the end result. Rigid internal fixation is mandatory whenever possible. Excellent results were obtained in 44% of cases and good in 44% of cases. Depressed and split depressed fractures with 3mm were taken as borderline. X-ray beam has to be tilted to 10°-15° while taking AP view in doubtful fractures and to know particular surface status. Meniscal tears if present can be diagnosed and repair or excisions has to be done. Status of ligaments, soft tissues around the knee play a pivot role in the functional outcome, so has to be documented and treated appropriately. Conclusion : Minimal invasive procedures like MIPPO have got better role to play in the days to come in closed tibial plateau fractures especially by using Locking Compression Plate (LCP).

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