title: Minimally Invasive Treatment of a Complex Tibial Plateau Fracture with Diaphyseal Extension in a Patient with Uncontrolled Diabetes Mellitus: A Case Report and Review of Literature.
abstract: Fractures of the proximal tibia comprise a huge spectrum of injuries with different fracture configurations. The combination of tibia plateau fracture with diaphyseal extension is a rare injury with sparse literature being available on treatment of the same. Various treatment modalities can be adopted with the aim of achieving a well-aligned, congruous, stable joint, which allows early motion and function. We report a case of a 40-year-old male who sustained a Schatzker type VI fracture of left tibial plateau with diaphyseal extension. On further investigations, the patient was diagnosed to have diabetes mellitus with grossly deranged blood sugar levels. The depressed tibial condyle was manipulated to lift its articular surface using K-wire as a joystick and stabilized with an additional K-wire. Distal tibial skeletal traction was maintained for three weeks followed by an above knee cast. At eight months of follow-up, X-rays revealed a well-consolidated fracture site, and the patient had attained a reasonably good range of motion with only terminal restriction of squatting. Tibial plateau fractures with diaphyseal extension in a patient with uncontrolled diabetes mellitus is certainly a challenging entity. After an extended search of literature, we could not find any reports highlighting a similar method of treatment for complex tibial plateau injuries in a patient with uncontrolled diabetes mellitus.
authors.affiliation: Department of Orthopaedics, LTMMC & LTMGH, Sion, Mumbai.
authors.forename: Ashok K
authors.initials: AK
authors.lastname: Rathod
authors.affiliation: Department of Orthopaedics, LTMMC & LTMGH, Sion, Mumbai.
authors.forename: Rakesh P
authors.initials: RP
authors.lastname: Dhake
authors.affiliation: Department of Orthopaedics, LTMMC & LTMGH, Sion, Mumbai.
authors.forename: Aditya
authors.initials: A
authors.lastname: Pawaskar
keywords: k wires; schatzker; tibial plateau fractures