Search

The head of the tibia is sometimes obliquely broken; and if it be fractured into the knee joint the treatment which it requires is similar to that which is necessary in the oblique fracture of the condyle of the Os femoris; i.e., Firstly, the straight position of the limb, because the femur preserves the proper adaptation of the fractured tibia by forming a splint to its upper portion, and keeping the articular surfaces in apposition. Secondly, a roller, to press one part of the broken surface against the other. Thirdly, a splint of pasteboard, to assist in the preservation of that pressure and fourthly, early passive motion to prevent ankylosis. All surgeries were performed under either spiral or lumbar plexus block with Sciatic nerve block. Tourniquet was not used in any of the patients. Patient was positioned supine on the fracture table. Traction was given along the axis of the limb, fracture reduced by closed manipulation with the help of C arm. Condyles were fixed with 6 mm cannulated lag screws and olive wires. Most of the patients were followed up for a period of 23 months. The longest follow up was 24 months and the shortest was 3 months. Average duration of follow up was 16.3 months. The maximum flexion achieved was 150 deg [2 patients] and minimum was 90 deg [4 patients] and 7 patients had a flexion of 135 deg. The average flexion achieved was 118.25 deg.