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Use of Skeletal Traction in Distal 1/3rd Tibia Intraoperatively for Achieving Reduction in Proximal Tibia Fracture

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Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 78-82 | Rajendraprasad Ramesh Butala, Sonali Das, Garvit Khatod

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.674

Submitted Date: 02 Oct 2024, Review Date: 28 Oct 2024, Accepted Date: 01 Nov 2024 & Published Date: 10 Dec 2024

Author: Rajendraprasad Ramesh Butala [1], Sonali Das [1], Garvit Khatod [1]

[1] Department of Orthopaedics, DY Patil Hospital, Navi Mumbai, Maharashtra, India.

Address of Correspondence

Sonali Das,
Department of Orthopaedics, DY Patil Hospital, Navi Mumbai, Maharshtra, India.
Email: drsonalidas@hotmail.com

Abstract

Introduction: Skeletal traction is a technique used to manage fractures by applying continuous axial force directly to the bone through a pin inserted through it. This method is particularly useful in maintaining proper alignment of fracture fragments, reducing pain, and preventing muscle spasms. It is commonly employed in the management of long bone fractures, such as those of the femur, especially when immediate surgical intervention is not possible. Skeletal traction stabilizes the fracture, facilitating proper healing and often serving as a temporizing measure before definitive surgical fixation. This study focuses on skeletal traction applied for the reduction of proximal tibia fractures. Studies on this subject are lacking as most established data focuses on its use for shaft femur fractures.
Materials and Methods: This study was conducted in a tertiary care teaching hospital by a single skilled surgeon team on 30 skeletally mature patients. Skeletal traction was applied for each patient using a Steinmann pin and 15% of the patient body weight over distal 1/3rd tibia shaft immediately post-trauma for 1 week and continued intraoperatively during primary fixation as plating. Pre-operative and post-operative radiographs were taken. Knee range of motion was measured using a goniometer at 2 weeks, 1 month, 3 months, and 6 months post-operative. Serial radiographs were taken immediately, 1 month, 3 months, and 6 months post-operative.
Conclusion: Skeletal traction applied over the distal 1/3rd shaft tibia shows promising results for comminuted proximal tibia fractures. It reduces fracture fragment displacement commonly occurring during manual traction.
Keywords: Skeletal traction, Proximal tibia, Tibial fractures, Lower extremity trauma.

References

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How to Cite this article: Butala RR, Das S, Khatod G. Use of Skeletal Traction in Distal 1/3rd Tibia Intraoperatively for Achieving Reduction in Proximal Tibia Fracture. Journal of Clinical Orthopaedics 2024:July-December:9(2);78-82.

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

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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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What’s New and Relevant in Proximal Tibia Fractures?

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Journal of Clinical Orthopaedics | Vol 8 | Issue 2 |  Jul-Dec 2023 | page: 45-49 | Sachin Kale, Nrupam Mehta, Arvind Vatkar, Rahul Ghodke, Joydeep Dey

DOI: https://doi.org/10.13107/jcorth.2023.v08i02.594

Authors: Sachin Kale [1], Nrupam Mehta [1], Arvind Vatkar [2], Rahul Ghodke [3], Joydeep Dey [1]

[1] Dr DY Patil Hospital Navi Mumbai, India,
[2] Orthopaedic Consultant at Fortis Hiranandani Hospital, Navi Mumbai, India,
[3] Assistant Professor, YMT Dental College and Hospital, Mumbai , India.

Address of Correspondence
Dr. Nrupam Mehta,
Department of Orthopaedics, Dr. DY Patil Hospital, Navi Mumbai, India.
E-mail: nrupam.m@hotmail.com

Abstract

Proximal tibia fractures include fractures of the tibia plateau and metaphyses and are relatively common injuries. The goals of treatment follow AO principles of anatomic reduction of the articular surface, restoration of limb alignment, length, and rotation. Despite notable advancements in implant design, management of proximal tibia fractures remains formidable. These fractures manifest as comminuted, intra-articular complexities, compounded by the inherent fragility of the osteoporotic bone, thereby rendering fixation a particularly intricate risk. In the realm of geriatric trauma, where comorbidities abound, therapeutic decision-making becomes a nuanced endeavor. We have aimed to bring together all the recent advances and literature in the management of proximal tibia fractures through this article.
Keywords: Proximal tibia, Plating, Nailing, Prosthesis.

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How to Cite this article: Kale S, Mehta N, Vatkar A, Ghodke R, Dey J. What’s New and Relevant in Proximal Tibia Fractures? Journal of Clinical Orthopaedics 2023;8(2):45-49.

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