الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
This study included twenty patients admitted to El-Hadra University Hospital from January 2018 till June 2019 suffering from diapho-metaphyseal tibial fractures.
On admission, all patients were assessed by history taking, clinical examination, and radiological assessment.
The youngest patient was twenty five years old and the eldest was seventy five years old with a mean of 48 years.
There was 11 males and 9 females. Twelve patients(60%) with right side involvement and eight patients(40%) with left side fractures.
Twelve patients(60%) had simple fractures, six patients(30%) had wedge fractures and two patients(10%) with comminuted fractures. sixteen patients(80%) were due to road traffic accident, one patient (5%) due to Falling from height, three patients(15%) due to falling down. All patients received analgesics, anti-oedematous measures and anticoagulants preoperative above knee slab.
Antibiotics were prescribed preoperatively at the time of induction and for 48 hours postoperatively. The limb was prepared and draped before reduction. The fracture was reduced closed or open via small incision then it was fixed by k-wires to maintain reduction then application of supracutaneous plate either DCP standard locked or distal femoral locked plate. Then suturing of the wound and sterile dressing.
Sutures were removed after 2 weeks and partial weight bearing was begun in the 2nd postoperative day except in cases of multifragmented fractures the in which weight bearing was delayed according to till start of union about one month . Full range of motion of knee and ankle joints should be started as tolerated immediately post-operatively The plate is removed one month after full union of the fracture ( about 12 weeks in 18 cases , 16 weeks in one case and 26 weeks in one case).
The final results were assessed according to the modified Klemm and Borner scoring system that 19 patients (95%) of had satisfactory results and got excellent score ranging from 15-19 and One patient (5%) got good score , he got 10 points according to the scoring system .