Tibial plateau fractures: an analysis of the results of treatment by osteosynthesis in 21 patients

Twenty-one patients with tibial plateau fractures were treated by osteosynthesis. The distribution of the fracture was fifteen unicondylar of which eight lateral and seven medial and the remaining six were Bicondyler. Two cases had A.C.L. and one had medial ligament tears. These cases with associated ligamentous injuries were treated surgically and did not influence the final outcome. Nineteen of the patients achieved an excellent or good result. The inferior result was seen in two patients due to deformity and instability and residual step in the weight-bearing area. The single most important factor in predicting outcome in a patient with a tibial plateau fracture was the adequacy of reduction. From this study we have to conclude that factors contributing to success were, careful preoperative planning, selection of the appropriate surgical approach, precise surgical technique including, adequacy of reduction, corticocancellous bone graft and stable osteosynthesis

Radial shortening for Kienbock's disease

Seven patients with Kienbocks disease were treated with radial shortening procedure to remove compressive stress from the damaged lunate. After an average of one year follow-up, relief of pain was satisfactory and the postoperative motion of the wrist were moderately improved. No non-union at the site of the radial osteotomy. The procedure appears to help to maintain carpal height, prevent further collpase of the lunate, encourage consolidation of the - fragmented lunate and increase grip strength. It appears as preferable method for the treatment of kienbocks' disease with zero or positive variance