A study of functional outcome of tibial condylar fractures treated with articular reconstruction

Author(s): Arohi Sharma, Dr. Ujwal Ramteke, Nikita Shetty, Nadir Shah, Ayush Singh and Jitsen Manna

Abstract: Objective: The goal of this study it to access the functional and radiological outcome of articular reconstruction as a treatment modality for depressed tibial condylar fractures, using autogenous iliac bone graft as a “filling agent”
Material and Method: 36 patients involved in this study had post traumatic, closed tibial condylar fractures, Shatzker types II, III, V, VI (articular depression). All patients were maintained in skeletal traction until skin condition improved following which the patients underwent surgical intervention. Articular reconstruction was done by creation a cortical window, elevating the depressed articular fragment through the window and filling up the void with autogenous iliac crest bone graft. The reconstruction was stabilized with locking plates. Patients were started with static quadriceps exercise and controlled passive movements immediately post operatively. Weight bearing was delayed for 10- 12 weeks in all patients. Clinical and radiological assessment was done on each follow-up.
Result: Out of the 36 patients, 28 patients had excellent and good results whereas 8 patients had poor results. Poor results were due to knee stiffness, short walking distance, incapacitating pain and decreased range of motion. 4 patients with poor results had anterior cruciate ligament laxity, reducing their clinical grading.
Conclusion: Stable fixation with near normal articular reconstruction and striving to achieve a functional range of motion gives good results in depressed tibial condylar fractures in absence of infection and associated ligamentous injury.

DOI: https://doi.org/10.22271/ortho.2018.v4.i2i.85