Minimally invasive osteosynthesis of distal tibial fractures using anterolateral locking plate: Evaluation of results and complications

Lakhotia, Devendra; Sharma, Gaurav; Khatri, Kavin; Gaurav, Kumar; Vp, Sharma; Farooque, Kamran

doi:10.1016/j.cjtee.2015.07.010

Cited by 12 publications

(12 citation statements)

References 33 publications

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“…[22][23][24][25] In a study it has been noticed that full range of ankle movements was attained in all the patients (100%) after 6 months (n=38). 26 But another study has shown that full range of ankle movements was achieved in all 26% cases after 6 months (n=19). 27 One more study supported the evidence and also showed that a complete range of ankle movements was attained in all 27% cases after 6 months (n=26).…”

Section: Discussionmentioning

confidence: 93%

Outcome of Minimally Invasive Percutaneous Plate Osteosynthesis Technique for Management of Extra Articular Distal Tibial Fractures

Akhtar

Ahmed²,

Khan³

et al. 2021

JRMC

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Objective: To assess the outcome of the minimally invasive percutaneous plate osteosynthesis (MIPPO) method applied for the management of extra-articular distal tibial fractures.Materials and Methods: This quasi-experimental study was conducted at the Department of Orthopaedic Surgery, Benazir Bhutto Hospital, Rawalpindi, Pakistan. Total 57 patients have included extra-articular type A distal tibial fracture, duration of injury <1 week, and competent neurological and vascular status of the fractured site. All the patients were treated with MIPPO Technique by using the distal tibial medial locking plate and the outcome of all patients was assessed radiologically in terms of union and functionally by using the Ovadia-Beals clinical scoring system. Data were analysed by using SPSS v. 21. Results: As per sample size calculation, 57 patients were included with a mean age of 37.19 ± 9.22 years. There were 45 (78.94%) male patients and 12 (21.05%) female patients. According to AO classification; the most common type was 43A1 with 31 patients (54.38%) whereas 18 (31.57%) were in Type 43A2 and 8 (14.03%) in Type 43A3. In our study, fracture union was achieved in a mean duration of 19.6 ± 3.45 weeks. When the functional outcome was analyzed, 41 (71.92%) patients had excellent outcome, 8 (14.03%) had good results, 5 (8.77%) had fair and 3 (5.26%) had poor outcome based on the subjective result and 44 (77.19%) patients had excellent, 7 (12.28%) had good, 3 (5.26%) had fair and 3 (5.26%) had poor result based on an objective result of Ovadia-Beals clinical scoring system. Conclusion: Thus MIPPO can be highly successful in achieving good to excellent outcomes in the maximum number of patients presented with a distal tibia fracture. So in the future, we can rely on this technique for such types of fractures.

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Section: Discussionmentioning

confidence: 93%

Outcome of Minimally Invasive Percutaneous Plate Osteosynthesis Technique for Management of Extra Articular Distal Tibial Fractures

Akhtar

Ahmed²,

Khan³

et al. 2021

JRMC

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“…Second, lateral malleolus fractures cause local swelling because of the thinner overlying skin and lack of skeletal muscle surrounding the fibula. Extensive soft tissue dissection is needed during the traditional operation to obtain precise fracture reduction and compression (26), which can lead to damage in the limited space and the rigid traditional implants have a high risk of complications such as wound dehiscence and infection, hardware prominence, neurovascular damage, and incision disunion (27,28). Furthermore, incorrect timing of the operation and application of standard large fragment plates have been associated with treatment failure because of steel plate exposure, joint pain or malformation, and even sepsis (25,29,30).…”

Section: Discussionmentioning

confidence: 99%

Combination of mini locking plate and nitinol arched shape-memory connector for purely lateral malleolus fractures: technique and clinical results

Xia¹,

Zhang²,

Ou³

et al. 2020

Ann Transl Med

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Background: Lateral malleolus fractures occur frequently. The common techniques for fixing purely lateral malleolus fractures are often challenging, owing to the extent of soft tissue damage and fracture non-union. Herein, we report a new treatment that entails minimally invasive insertion and continuous compression of the broken ends as a novel technique, and evaluate its clinical results. Methods: This study enrolled 21 patients (13 males and 8 females; mean age 32.06±3.45 years, range 23-69 years) with purely lateral malleolus fractures. Each patient underwent open reduction treatment with a mini locking plate for internal fixation and compression of the fracture end with an Arched Shape-MemoryConnector (ASC). The clinical assessments were made using the American Orthopedic Foot and Ankle Society (AOFAS) scores, which were recorded at the final follow-up visit.Results: The patients were followed for an average of 14.7±1.2 months (range, 12-18 months). None of the patients showed surgical failure, and all of the purely lateral malleolus fractures healed in an average of 12.6±1.5 weeks (range, 10-16 weeks). The mean AOFAS score was 88.94 (range, 83-90). Conclusions:The new treatment had beneficial outcomes for purely lateral malleolus fractures. Mini locking plates are minimally invasive for surgical intervention, and combined with continuous concentrated compression with an ASC to accelerate osseous healing, they aid in restoration of function and enable early rehabilitation with a low incidence of postoperative complications.

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“…Padmanaban kosalaraman et al [22] Devendra Lakhotia et al [23] Present study Wound dehiscence/Superficial infection 16% 12% 2 (10%) Non-union 8% 0 2 (10%) Superficial peroneal nerve neurapraxia 0 1(2%) 1 (5%) Deep infection 0 0 0 Implant failure 4% 0 0…”

Section: Complicationsmentioning

confidence: 96%

“…Mean # union duration Devendra Lakhotia et al [23] 2016 18 Weeks Rohit varma et al [24] 2017 18 weeks Padmanaban kosalaraman et al [23] 2017 21.4 weeks Daniel et al [25] 2016 15 weeks Present study 2017-18 16.9 weeks…”

Section: Year Of Studymentioning

confidence: 99%

Analysis of functional outcome of anterolateral plating in tibial pilon fractures

Dhar¹,

Daolagupu²,

Gowtham³

2018

Int. J. Orthop. Sci.

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Introduction: Tibial pilon fractures account for 1% to 10% of all lower extremity injuries. The difficulty in managing these injuries is primarily due to the precarious vasculature around the ankle. Medial plating using LCP on the subcutaneous medial border of distal tibia resulted in a significant rate of wound dehiscence and deep infection. Plating on the lateral surface of tibial plafond is a new entity and the anterolateral approach is gaining popularity for the fixation of tibial pilon fractures. Materials and methods: In our study 20 cases with a minimum follow up of 4 months and maximum of 12 months with an average of 9 months was carried out. Anterolateral approach to ankle was used and anterolateral locking compression plates are placed through the interval between the anterior and lateral compartments of leg. All cases were assessed postoperatively using the Kaikkonen clinical ankle score and Teeny wiss radiological score. Results: 20 fractures united with a mean duration of 16.9 weeks. In our study we had excellent functional outcome in about 20% of cases, good functional outcome in 60% of cases fair and poor outcome 20% of cases each based on Kaikkonen Ankle Score. In our study the complication we met were 2 cases (10%) of wound dehiscence and superficial infection which healed by secondary intention. One patient had superficial peroneal nerve neurapraxia which improved gradually over time without any intervention. One patient had nonunion which required bone grafting later on for fracture healing. Conclusion:Anterolateral approach with anterolateral plating in the distal tibia fractures is safe easy and effective and has excellent to good functional outcome in most of the fracture types.

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Minimally invasive osteosynthesis of distal tibial fractures using anterolateral locking plate: Evaluation of results and complications

Cited by 12 publications

References 33 publications

Outcome of Minimally Invasive Percutaneous Plate Osteosynthesis Technique for Management of Extra Articular Distal Tibial Fractures

Outcome of Minimally Invasive Percutaneous Plate Osteosynthesis Technique for Management of Extra Articular Distal Tibial Fractures

Combination of mini locking plate and nitinol arched shape-memory connector for purely lateral malleolus fractures: technique and clinical results

Analysis of functional outcome of anterolateral plating in tibial pilon fractures

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