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Study of Functional Outcome of Intra-articular Proximal Third Tibia Fractures Treated with Locking Compression Plate

Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 88-94 | Adnan Asif, Saurabh Harikant Yadav, P Gokula Kumar, Pawar Bhushan Kumar Bhajandas, Atul Jain, Lalit C Panchal

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.678

Submitted Date: 13 Jul 2024, Review Date: 19 Aug 2024, Accepted Date: 16 Sep 2024 & Published Date: 10 Dec 2024


Author: Adnan Asif [1], Saurabh Harikant Yadav [1], P Gokula Kumar [1], Pawar Bhushan Kumar Bhajandas [2], Atul Jain [3], Lalit C Panchal [1]

[1] Department of Orthopaedics, K B Bhabha Municipal General Hospital, Mumbai, Maharashtra, India,
[2] Department of Orthopaedics, Chhatrapati Shivaji Maharaj Hospital and Rajiv Gandhi Medical College, Thane, Maharashtra, India,
[3] Department of Orthopaedics, Swami Dayanand Hospital, New Delhi, India

Address of Correspondence

Adnan Asif,
K B Bhabha Municipal General Hospital, Maharashtra, Mumbai, India.
E-mail: adnan.asif1092@gmail.com


Abstract

Background: The study aimed to provide an estimate of the functional outcome following the use of locking compression plate (LCP) in the management of intra-articular proximal third tibia fractures. Materials and Methods: A prospective cohort study was carried out on 30 intra-articular proximal third tibia fractures which were operated with LCP fixation between August 2020 and July 2021. Primary outcome measurement was carried out using Rasmussen’s functional knee grading criteria. Results: Functional outcome assessed by Rasmussen’s functional knee grading criteria showed Excellent results in 16/30 (53.33%) of patients, good result in 9/30 (30%) of patients (overall 83.33% acceptable results), and fair in 4/30 (13.33%) and poor result in 1/30 (3.33%) of patients. Post-operative complications occurred in eight out of 30 of our patients (26.67%). Open reduction and internal fixation was more commonly used (76.67%) as compared to minimally invasive percutaneous plate osteosynthesis (23.33%). We commonly applied a combined principle of fixation (bridging + compression) across 46.67% of our fracture fixations. Primary surgical approach used was almost equal across our study between medial/posteromedial (53.33%) and anterolateral (46.67%).
Conclusion: We conclude that the LCP system with its various type of fixation act as a good biological fixation including difficult fracture situations. However, this also involves the risk that may occur unless properly planned preoperatively and follow guided principles intraoperatively.
Keywords: Proximal tibia, locking compression plate, Rasmussen functional knee grading criteria.


References

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How to Cite this article: Asif A, Yadav SH, Kumar PG, Bhajandas PBK, Jain A, Panchal LC. Study of Functional Outcome of Intra-articular Proximal Third Tibia Fractures Treated with Locking Compression Plate. Journal of Clinical Orthopaedics 2024:July-December:9(2)88-94.

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Management of Periprosthetic Femoral Fractures following Total Hip Replacement: A Case Series

Journal of Clinical Orthopaedics | Vol 7 | Issue 1 |  Jan-Jun 2022 | page: 100-103 | Lokesh Kumar Yogi, Vijay Chandrakant Shinde, Moti Janardhan Naik, Vikash Kumar

DOI:10.13107/jcorth.2022.v07i01.485


Author: Lokesh Kumar Yogi [1], Vijay Chandrakant Shinde [1], Moti Janardhan Naik [1], Vikash Kumar [2]

[1] Department of Orthopaedic Surgery, Government Medical College, Aurangabad, Maharashtra, India.

[2] Department of Orthopaedic Surgery, Deen Dayal Upadhyaya Hospital, New Delhi, India.

Address of Correspondence
Dr. Lokesh Kumar Yogi,
Department of Orthopaedic Surgery, Government Medical College, Aurangabad, Maharashtra, India.
E-mail: lokesh.k.yogi@gmail.com


Abstract

Background: Periprosthetic femoral fractures following total hip arthroplasty (THA) are not very uncommon. At present the Vancouver classification provides management algorithm for deciding treatment options but treatment options may vary between surgeons, where as in this study most patients managed were according to Vancouver classification management algorithm. The most common treatment modality for treating periprosthetic femoral fractures around a well-fixed stem is with osteosynthesis, but fracture with loose stem requires revision arthroplasty and fracture with poor bone requires bone graft augmentation.

Methods: We reviewed 21 consecutive cases with periprosthetic femoral fractures in association with THA between June 2018 and December 2020. Locking and non locking compression plates, wires, cables system were used for osteosynthesis. Most of fractures were managed according to Vancouver classification management algorithm but modified in some cases according to the surgeon’s skills and judgment.

Results: According to Vancouver classification, two patients had AL fractures, two patients had AG fractures, twelve Patients had B1, five patients had B2, two patients had B3 and one patient had type C fracture. Of these two cases were treated by conservatively, sixteen cases were treated by osteosynthesis, three cases by revision arthroplasty.

Conclusion: The careful analysis of implant stability and fracture patterns is crucial for the optimal treatment of Periprosthetic femoral fractures. Expert Surgeon’s skills are needed to deal with periprosthetic femoral fractures.

Keywords: Locking compression plate, periprosthetic fractures, total hip arthroplasty, Vancouver classification


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How to Cite this article: Yogi LK, Shinde VC, Naik MJ, Kumar V. Management of periprosthetic femoral fractures following total hip replacement: A case series. Journal of Clinical Orthopaedics Jan-Jun 2022;7(1):100-103.

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