Management of diaphyseal tibial fractures by plate fixation with absolute or relative stability: a retrospective study of 45 patients

Sandoval, Juan Manuel; Rueda, José Luis Osma; Daza, Alejandro Sandoval

doi:10.1136/tsaco-2016-000029

Cited by 6 publications

(2 citation statements)

References 27 publications

(23 reference statements)

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“…It allows earlier weight-bearing and a shorter hospital stay [ 13 ]. Whereas indications for the plate in treating tibial shaft fracture are limited [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Finite element analysis modeling of plates versus intramedullary nails in closed comminuted midshaft tibial fractures

El-Desouky

Saleh

Amr

et al. 2022

SICOT-J

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Background: Tibial shaft fractures are usually treated by interlocking nails or plates. The ideal implant choice depends on many variables. Aim: To assess the mechanical behavior of interlocking nails and plates in the treatment of closed comminuted midshaft fractures of the tibia using finite element analysis. Material and methods: This is a prospective study of 50 patients with a mean age of 28.4 years with closed comminuted fractures of the midshaft of the tibia. Data evaluation was done by Finite element analysis (FEA). Fixation was revised in two cases. Results: After load application, there were significant differences in both bending (P = 0.041) and strain percent (P = 0.017), reflecting that interlocking nails were superior to plates. There were also significant differences between titanium and stainless-steel materials in bending (p = 0.041) and strain percent (p = 0.017) after applying load, indicating that titanium was superior to stainless steel. Conclusion: Interlocking nails are superior to plates in treating midshaft tibial fractures. The use of blocking screws may be needed in interlocking nails depending on the pattern and extension of the fracture.

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“…It allows earlier weight-bearing and a shorter hospital stay [ 13 ]. Whereas indications for the plate in treating tibial shaft fracture are limited [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Finite element analysis modeling of plates versus intramedullary nails in closed comminuted midshaft tibial fractures

El-Desouky

Saleh

Amr

et al. 2022

SICOT-J

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“…Ale pouze v pěti případech (10 %) překračovala hodnoty všeobecně považované už za malpozici. Obdobné hodnoty v rozmezí 5-14 % jsou udávané i ve světové literatuře (13,20,23,24). Malpozice je dána snahou o zavřenou repozici s minimalizací dalšího traumatizování měkkých tkání.…”

Section: Původní Práce Original Paperunclassified

Treatment of Fractures of the Distal Third of Tibia Diaphysis by MIPO Technique

Schwarz¹,

Majerníček²,

Chomiak³

2020

Acta Chir. orthop. Traum. Cech.

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PURPOSE OF THE STUDY MIPO (Minimally Invasive Plate Osteosynthesis) technique is currently a commonly used method to treat fractures of the distal third of tibia diaphysis. At the same time, it is just like other methods accompanied by a relatively high complication rate. The purpose of this study was to determine whether the use of this technique at our department is effective and whether the complication rate does not differ considerably from values reported by literature. MATERIAL AND METHODSIn the period 2014-2016, minimally invasive plate osteosynthesis was performed in a total of 42 patients, who had suffered a fracture of the distal third of tibia diaphysis. They sustained a low-energy trauma. The mean age of patients was 50 years (range 27-86 years) and the mean follow-up period was 11.8 months (range 1.5-38 months). All the patients were treated with a minimally invasive technique with the use of subcutaneous LCP. In 41 patients (98%) it was inserted via anteromedial approach. In one patient only (2%), the LCP was inserted via anterolateral approach due to the unfavourable local finding on the medial side of the distal lower limb. RESULTSOf the total number of operated patients, 35 patients (83%) underwent surgery within 24 hours of injury, including two patients in whom an external fixator was used. The mean operative time was 61 minutes (range of 30-150 minutes). The primary healing occurred in 93% of patients with radiological signs of healing within 5.6 months on average (range of 1.5-16 months). Time to full weight bearing was 4.2 months on average (range of 1.5-16 months). Delayed healing was observed in four patients. In three patients, a non-union developed, necessitating revision surgery. Infectious complications were reported in seven patients, in three of whom deep wound infection developed. In one case, the chronic infection resulted in a lower limb amputation. In five patients mal-union occurred. DISCUSSIONThe outcomes achieved by the authors in treating fractures of the distal third of tibia diaphysis with a minimally invasive technique do not considerably differ from the outcomes reported by other authors in literature. In terms of the outcomes and the complication rate, the MIPO method is comparable to the treatment of these fractures with the use of nails. Limiting for fracture healing is the vascular supply. Therefore, in treating these injuries it is necessary to proceed with minimum invasiveness and carefulness and to seek to limit any additional trauma to soft tissues, thus also to vascular supply. In case of syndesmosis failure, the concurrent treatment of distal fibula fractures is clearly indicated. In case of intact syndesmosis, fibular osteosynthesis and the sequence of procedures are to be decided by the surgeon. At present, rigid osteosynthesis is being abandoned for potential slower healing up to development of non-unions. CONCLUSIONSThe treatment of fractures of the distal third of tibia diaphysis remains an unsolved issue despite the development of stateof-the art materials...

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A Review on the Effect of Biomechanical Aspects and the Type of Stability Fixation on the Bone Fracture Healing Process

Rathor

Uddanwadiker

2021

Lecture Notes in Mechanical Engineering

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Bone fracture healing is a complex process that involves both biological and mechanical aspects. There are various factors that influence the time period of fracture healing. Over the past decade, many researchers reported the different factors on which the bone fracture healing process depends. These researches also help the orthopedic surgeon to bring the upgradations in their surgical techniques. The type of stability fixation given to the fracture during surgery, the flow of body fluid at the fracture site and direction of interfragmentary motion, i.e., micromotion during the load-bearing period, are some important factors that are discussed by the various researchers in the past. The aim of this review is to highlight the existing knowledge about the biology of bone fracture repair, the recent research on bone fracture and the effect of biological and mechanical aspects on the bone fracture healing process.

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Management of diaphyseal tibial fractures by plate fixation with absolute or relative stability: a retrospective study of 45 patients

Cited by 6 publications

References 27 publications

Finite element analysis modeling of plates versus intramedullary nails in closed comminuted midshaft tibial fractures

Finite element analysis modeling of plates versus intramedullary nails in closed comminuted midshaft tibial fractures

Treatment of Fractures of the Distal Third of Tibia Diaphysis by MIPO Technique

A Review on the Effect of Biomechanical Aspects and the Type of Stability Fixation on the Bone Fracture Healing Process

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