Minimally invasive plate osteosynthesis (MIPO) is beneficial for proximal tibial fractures since these injuries are mostly caused by high energy traumas. The advantages of MIPO are minimization of soft tissue dissection and preservation of periosteal vascularization. Lateral plating has mostly developed as MIPO for proximal tibial fractures. We introduce minimal invasive percutaneous plate stabilization using a medial locking plate as alternative treatment for proximal tibial fractures.
Tibial Fractures

No abstract available.
Tibial Fractures*

No abstract available.
Tibial Fractures*

No abstract available.
Tibial Fractures*

No abstract available.
Tibial Fractures*

No abstract available.
Tibial Fractures*

Acute Compartment Syndrome is a limb-threatening emergency and it occurs most commonly after fractures. The aim of our study is to find out the effectiveness of serial measurement of differential pressure in closed tibial diaphyseal fractures, in diagnosing acute compartment syndrome, using Whiteside’s technique. A total of 52 cases in the age group of 15 to 55 years admitted with closed fractures were studied for serial compartment pressure as well as serial differential pressure. Eight patients had persistent compartment pressure > 40mmHg, out of which only two patients had persistent differential pressure < 30mmHg and these two patients underwent fasciotomy. Thus, by measuring the compartment pressure serially and calculating differential pressure serially, acute compartment syndrome can be diagnosed or ruled out with higher precision, so that unnecessary fasciotomies can be avoided.
Tibial Fractures

Introduction: Intramedullary nailing has been used frequently for the treatment of tibial diaphyseal fractures. Chronic anterior knee pain has been considered the most frequent post-operative complication of this technique. We investigated the relationship between anterior knee pain and position of nail tip in proximal tibia. Methods: 103 patients were selected among patients who underwent interlocking nailing in our institution. Patients with other factors that might cause anterior knee pain were excluded. In all patients intramedullary nailing was done using transpatellar approach. The patients were evaluated in two groups, 42 patients had anterior knee pain (Group A), whereas 61 patients did not have pain (Group B). The distance from nail tip from tibial plateau was measured on lateral radiographs. Nail prominence from anterior tibial cortex was also measured. Results: The two groups were similar with respect to gender and follow up period. Out of 42 patients who had knee pain 21 (50%) had nail tip within proximal third distance from plateau to tibial tuberosity. Twenty-four patients (42%) among knee pain group had nail prominence of more than 5mm from anterior tibial cortex followed by 12 patients (29%) within 5mm and 12 patients (29%) nail tip buried within the anterior cortex. Conclusion: A greater incidence of knee pain was found when nail was prominent more than 5mm and when it is in the proximal third distance from tibial plateau to tuberosity. Patients should be aware of high incidence of knee pain when the nail tip is placed in proximal third and prominence of more than 5mm.
Tibial Fractures

Open tibial fractures result in high rates of complications. This study aims to elucidate the risk factors causing these complications, and suggest antimicrobial regimens based on the organisms grown in post-operative infections. Over a period of five years, 173 patients had sustained open tibial fractures and undergone operative treatment at a single institution. All surgical data was gathered retrospectively through online medical records. Thirty-one patients (17.9%) had sustained post-operative bony complications, while infective complications were reported in 37 patients (21.4%). Patients with Gustilo type III fractures were found to be more than three times as likely to sustain post-operative infective (p=0.007) or bony (p=0.015) complications, compared to Gustilo type I or II fractures. The fracture location and time taken to fixation did not significantly affect the complication rate, but results were trending towards significance. The commonest cause of infective complications were hospital-acquired organisms, such as Methicillin-resistant staphylococcus aureus (40.5%). Closer monitoring of patients sustaining high grade Gustilo open fractures, as well as antimicrobial prophylaxis for both hospital-acquired organisms and environmental contaminants, will result in the best outcome for patients. Further studies with larger sample sizes are warranted, to determine the significance of fracture location and time taken to fixation on complication rates.
Tibial Fractures

No abstract available.
Tibial Fractures*