Abstract

Road traffic accidents contribute to the majority of human morbidity and mortality in this rapidly expanding world, which is why they are appropriately referred to as the epidemic of the modern age. The term "tibialpilon" (also known as "tibial plafond") refers to a condition where the talus acts as a hammer, striking and breaking the distal tibia.In this study, we wanted to evaluate thedistal end of tibia fracture treated withanterolateral plating. Methods: This was a hospital based observational study conducted among 50 patients who presented with fracture of distal end of tibia to the Department of Orthopaedics in a tertiary care centre, over a period of 20 months, after obtaining clearance from Institutional Ethics Committee, and written informed consent, from the study participants. Results: The mean time for union was 19.4 (3.8) weeks and all except, two cases resulted in complete union. The fracture reduction by radiology (Tenny & Wiss) score was excellent, good and fair in 20.0 %, 40.0 % and 35.0 % of patients with fracture of distal end of tibia. The fracture reduction was observed to be poor among two patients. The functional recovery by Kaikonnen Ankle Score was excellent, good and fair in 15.0 %, 55.0 % and 25.0 % of patients. There was significant increase in the range of motion (dorsiflexion) during the follow-up (6.50 at six weeks to 13.80 at nine months; p = 0.008) and also there was significant increase in plantar flexion during the follow-up (9.40 at six weeks to 30.20 at nine months; p < 0.001). Conclusion: Anterolateral plating gives good results in the treatment of fracture of distal end of tibia with a significant increase in the range of motion (dorsiflexion) and plantar flexion. Incidence of flap necrosis or secondary osteoarthritis is very less.

Description