Direct Access to the Proximal Posteromedial Tibia for Fixation of Large Posteromedial Tibial Fractures Utilizing the “Lobenhoffer Approach” in Lateral Decubitus Position
Journal Title: Journal of Pakistan Orthopaedic Association - Year 2020, Vol 32, Issue 03
Abstract
Objective: To determine the effectiveness and safety of “Lobenhoffer approach” for treating large posteromedial tibial fractures of the proximal tibia. Methods: The descriptive study was carried out from 23rd January 2017 to 25th December 2019 at Qaisrani Medical Center (QMC) Multan. All patients of proximal tibia fractures having a large posteromedial plateau fragment alone or in combination with bicondylar fractures (Hohl and Moore type I /Schatzker type IV) fulfilling the inclusion criteria were operated with Lobenhoffer approach. Fracture reduction was confirmed by per-op visualization with image intensifier and post operatively with radiographs. The radiological reduction was anatomical if fracture was accurately reduced without any step and non anatomical if step was noted(? 2mm).The patients were followed up for one year and radiological evaluation, functional assessment and any potential complication was documented. Comparison of important outcome variables were made and P value was calculated with the help of Chi square test (P value < 0.05 was considered significant) Results: A total of 15 patients were included in our study. The mean age was 36.73± 10.9 years (range 18 to 56 years). Posteromedial and bicondylar fracture was present in 12(80%) patients while 3(20%) patients had isolated posteromedial fracture. Immediate post operative radiographs revealed anatomical reduction in 12(80%) and non anatomical reduction in 03(20%) patients (P >0.05). No per operative or immediate post operative complication was noted. Union was achieved in all patients. Majority(73.3%,n=11) patients achieved full range of knee motion, only 1(6.6% ) patient had extension lag of 10 degrees( P < 0.05 ). Grade II osteoarthritis was noted in 2(13.3%) patients(P >0.05). Conclusion: Accurate anatomical reduction and excellent functional outcome can be achieved by fixing posteromedial tibial fractures through Lobenhoffer approach in lateral decubitus position. It is a safe approach and has no major per operative or post operative complications. We recommend this approach for all proximal tibial fractures with posteromedial fragment.
Authors and Affiliations
Muhammad Imran Haider1, Kashif Siddiq Ramay2, Zulfiqar Ahmed3, M Iqbal Buzdar4, Ghulam Haider Qaisrani5,Irfan Ali Shujah6
Outcome of Supracondylar Fractures of Humerus in children treated with Dorgan’s Surgical Technique
Objective: To determine the functional and radiological outcome of supracondylar fractures humerus in children treated with Dorgan’s lateral cross pinning technique. Methods: This descriptive study was carried out at Or...
Frequency of Musculoskeletal Pain Among Hospital Cleaning Workers in Tertiary Care Hospitals in Lahore.
Objective: To determine the frequency of musculoskeletal pain among hospital cleaning workers in tertiary care hospitals of Lahore. Methods: This cross-sectional study was conducted in University of Lahore Teaching Hos...
Bilateral Insufficiency Fractures of Hip with SIF A Case Report and Literature Review
Multiple Insufficiency fracture is a rare injury. To have a compression Sub Chondral Insufficiency fracture (SIF) in same hip is even rarer. The author's report an elderly lady with osteoporosis who had stress fractures...
Out Come of Kelafong Procedure in The Treatment of Spinal Tuber Culosis
Objective: To find the outcome of Kelafong procedure in the treatment of spinal tuberculosis Methods: This prospective study was conducted on 8 patients diagnosed with active spine tuberculosis in the Department of Or...
Awareness Regarding Clubfoot in Parents
Objective: To assess awareness and knowledge regarding club foot in parents of children with clubfoot. Methods: This cross sectional study was conducted in Dow University hospital among 105 parents of children who hav...