A prospective study to evaluate the postoperative functional outcome of distal tibia fractures managed with locking compression plating
Arun Vishnu M P, Jamsheed Thottiyan, John Thayyil John, Divya G, Joice Varghese M J, Jerry Jose Malppan
Introduction: Fractures of the distal tibia remains as one of the most threatening therapeutic challenges to an orthopedician particularly due to the associated soft tissue injury. Limited soft tissue coverage and development of edema immediately after the fracture augments complication status. The spectrum of treatment extends from conservative management to open reduction and internal fixation of which MIPO (Minimally Invasive Plate Osteosynthesis) technique is the most recent advancement. Aim: To assess the functional outcome of distal tibia fractures managed with locking compression plate using American orthopaedic society foot and ankle scoring and to assess the relationship between type of fracture, mode of injury and associated co morbidities in final functional outcome. Materials and Methods: Unicentric, prospective, observational study was conducted with 49 patients selected for the management of distal tibia fracture using Locking Compression Plate and followed up in the OPD after 6 weeks, 12 weeks, 6 months and 12 months during the period of June 2017- June 2019. The average age of the study group was 43.82 years with 71.4% males and 28.6% female patients. 36.7% of the cases were type 1 fracture and 32.7% of the cases were type 2 fracture and 30.6% of cases were type 3 fracture (AO). 38.8% of the cases had diabetes mellitus, 24.5% of the cases had hypertension. Results: Age had a significant statistical relation with final functional outcome. It was noted that as the age increases there was a higher occurrence of bad or acceptable outcome compared to younger age groups (p = 0.042). There was a statistically significant association between the fracture type and final functional outcome. Excellent or good functional outcome occur more in Type A and B when compared to Type C where there are more occurrence of bad or acceptable outcome (p = 0.011). It was also noted that bad/ acceptable outcome was Significantly lower in patients without diabetes compared to cases with diabetes. Conclusion: Distal tibia fractures are challenging fractures for fixation. It is imperative to attain good reduction of the fragments, respect the surrounding soft tissue cover, Stable fixation, control of co morbidities, proper rehabilitation and physiotherapy to obtain an excellent functional outcome among the patients. Locking compression plating for distal tibia is an adequate, advantageous and attractive option for fixation of distal tibia fractures.
Arun Vishnu M P, Jamsheed Thottiyan, John Thayyil John, Divya G, Joice Varghese M J, Jerry Jose Malppan. A prospective study to evaluate the postoperative functional outcome of distal tibia fractures managed with locking compression plating. International Journal of Orthopaedics Research, Volume 4, Issue 1, 2022, Pages 31-37