Abstract

Supracutaneous plating: Use of locking compression plate as external fixator for intra-articular compound fractures

Compound intra articular fractures of distal femur and proximal tibia is the one of the most common injury encountered by orthopaedic surgeons these days. Metaphyseal juxtaarticular and intraarticular compound fractures are not good indication for intramedullary nails and open reduction and plate fixation due to limitation of short proximal and distal fragment and marked communition at these areas with greater chances of infection, soft tissue complications and risk of plate exposure. These fractures are mostly managed by external fixators, ring fixators or hybrid fixators. We managed these fractures by locking compression plates as an external fixator; supracutaneous plating and results evaluated. A study of eight (six male and two female) patients with compound injuries to distal femur and proximal tibia or both during a period of one year. Total ten fractures were treated by external fixation i.e precontoured anatomical locking plate application. Cases were followed up at regular interval and functional outcome assessed using knee society score. Mean period for implant in situ was around 16 weeks.100% fracture union rate was achieved. There was 1 case of low grade infection at fracture site seen. Good to excellent outcome achieved according to knee society score in 87.5% cases. We concluded that primary plating as an external fixator of compound fracture is a good method of management. There is a high rate of union with a low complication rate when using external locked plating for open fractures of distal femur and proximal tibia.

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