Minimally invasive plate osteosynthesis for short oblique diaphyseal tibia fractures: does fracture site affect the outcomes?

Eken, Gokay; Ermutlu, Cenk; Durak, Kemal; Atıcı, Teoman; Sarısözen, Bartu; Cakar, Adnan

doi:10.1177/0300060520965402

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…Saglam achieved union after treatment with the IMN method after an average of 4.4 months [21]; comparing the time of union between patients treated with IMN vs. MIPO in both groups, Kang achieved union after an average of 3 months [22], and Vidovic achieved union in patients treated with the MIPPO method after an average of 4.9 months [23], while Eken reports an average union time for MIPPO treatment of 4.23 months [24], and Marroquin-Herrera af-ter fixation using an LCP plate achieved union in 37.5% of cases after 6 weeks, in 40 % of cases after 3 months, in 22.5% of cases after 6 months [25].…”

Section: Discussionmentioning

confidence: 96%

The application of intramedullary nails and transmedullary support screws in surgical treatment of distal tibia fracture

Bęcki¹,

Falis²,

Synder³

et al. 2023

Chir Narzadow Ruchu Ortop Pol

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Introduction. Fractures of the distal tibia are a difficult treatment problem due to the specific anatomy of this area and the soft tissue injuries resulting from trauma. A distal fracture is short, has a wide marrow cavity, and the asymmetric muscle forces acting on it can cause secondary displacements despite the originally correct positioning. Against the background of the problems presented above, the fixation with an intramedullary nail (IMN) with the use of TMS (trans medullary support) screws directional screws seems to be the best alternative for treatment. Aim. The aim of this study was to evaluate the bone fracture repositioning after surgical treatment of tibia fracture, the time of bone healing and the function of the upper ankle joint. Materials and methods. Forty patients treated surgically due to a fracture of the distal tibia with the use of an intramedullary nail and TMS screws were included in this study. The mean follow-up time was 25.3 months. The function of the ankle joint of the injured limb was evaluated using the AOFAS, VAS and SF-36 questionnaires. Radiological documentation was assessed in terms of correct bone fragment repositioning, placement of directional screws and correct union of the fibula. Post-operative X-rays as well as X-rays taken at the end of treatment in AP and lateral projection were also assessed, evaluating LDTA (lateral distal tibial angle) and ADTA (anterior distal tibial angle). Results. The function of the ankle joint after surgical treatment of a distal tibia fracture using the IMN + TMS method is as follows: AOFAS score 91.5, VAS 2.2 / 10 points. The range of motion of the ankle joint: the angles of ankle movement were significantly greater in the case of the uninjured limb compared to the injured one. Bone union was obtained in all patients. In 80% of patients, it was achieved in less than 6 months. Assessment of repositioning after surgery – mean LDTA angle after surgery was 89 and mean ADTA angle after surgery was 86 (standard LDTA 90, ADTA 85). Conclusions. The function of the ankle joint after treatment of a distal tibial fracture with an intramedullary nail and TMS screws according to the AOFAS and VAS scale was very good and allowed for the anatomical bone fragment fixation. The bone healing after fixation of the distal tibial fracture with an intramedullary nail and TMS screws was shorter than 6 month in most cases.

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Section: Discussionmentioning

confidence: 96%

The application of intramedullary nails and transmedullary support screws in surgical treatment of distal tibia fracture

Bęcki¹,

Falis²,

Synder³

et al. 2023

Chir Narzadow Ruchu Ortop Pol

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“…Tibial malunion occurs in 3–50% of conservative treatment and up to 20% of surgical fixation [ 10 ]. Although plate osteosynthesis has the lowest malunion rate for tibial fractures [ 11 , 12 , 13 ], the malunion rate reaches up to 8.3% even after tibial plating [ 14 ], and midshaft fractures do not have a lower malunion rate than distal fractures [ 15 ]. The mean angulation after tibial plating reaches up to 2.6–3.1° even on a single coronal plane [ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Does a Customized 3D Printing Plate Based on Virtual Reduction Facilitate the Restoration of Original Anatomy in Fractures?

Shin

Kim²,

Yoon³

et al. 2022

JPM

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The purpose of this study was to evaluate the restoration of original anatomy after fixation of sawbone fractures using case-specific 3D printing plates based on virtual reduction (VR). Three-dimensional models of 28 tibia sawbones with cortical marking holes were obtained. The sawbones were fractured at various locations of the shaft and 3D models were obtained. The fractured models were reduced virtually and customized non-locking metal plates that fit the reduced model were produced via 3D printing. The fractured sawbones were actually fixed to the customized plate with nonlocking screws and 3D models were generated. With the proximal fragments of the 3D models overlapped, the changes in length, 3D angulation, and rotation of the distal fragment were evaluated. Compared to the intact model (IN), the virtual reduction model (VR) and the actual fixation model (AF) showed no significant differences in length. Compared to the IN, the VR and the AF had mean 3D angulations of 0.39° and 0.64°, respectively. Compared to the IN model, the VR and the AF showed mean rotations of 0.89° and 1.51°, respectively. A customized plate based on VR facilitates the restoration of near-original anatomy in fractures of tibial sawbone shaft.

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“…Поява нових біодеградуючих матеріалів на основі полілактиду (полімолочна кислота) і пластиків [10], а також вуглецевих інертних матеріалів [11] відкрила нові можливості накісткового остеосинтезу, здатного конкурувати з іншими видами.…”

Section: методи хірургічного лікування діафізарних переломів кістокunclassified

Surgical methods of treatment for tibial diaphyseal fractures

Stroiev,

Karpinska

2024

TRAUMA

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Background. Bone fractures are a public health concern. In recent years, there has been an upward trend in body weight of people of all age groups. Obesity has long been thought to help protect against fractures, but recent studies have shown that for every 5 cm increase in waist circumference, the risk of any fracture is 3 % higher. The purpose: according to the meta-analysis of modern medical literature, to determine the main directions of surgical treatment for long bone fractures, their advantages, and disadvantages, including in overweight patients, the features of diaphyseal fracture fixation in overweight patients. Materials and methods. A meta-analysis of special literature from scientific databases was conducted: Cochrane Library, Scopus, National Library of Medicine — National Institutes of Health, ReLAB-HS Rehabilitation Resources Repository. One hundred and thirty articles were analyzed, from them 31 were selected, which, in our opinion, reflect the purpose of the study. Results. All methods of surgical fixation of fractures have their advantages and disadvantages. The frequency of nonunions caused by intramedullary fixation of the femoral shaft can reach 10 %, and varus/valgus and rotational deformities and shortening can also be observed. But the use of locking screws prevents the occurrence of most complications. When fixing the fractures with plates, the main complications are related to superficial and deep infections, which were more often observed in overweight patients. The analysis demonstrated that in overweight and obese patients, the main complicating factor is not the method for fixing the fracture zone, but factors related to the health of the patient himself. So, despite the fact that the results of treatment of fractures in patients with normal weight and obesity did not have a statistically significant difference, an increase in cardiovascular complications, exacerbation of chronic respiratory diseases was observed. Moreover, it is the presence of concomitant diseases that often makes surgical intervention impossible. Conclusions. There is a large amount of research on surgical methods of fixing tibial diaphyseal fractures, but data on the choice of fixation method in overweight and obese patients as a separate approach were not found. There are data on complicating factors of excess weight in the treatment of fractures and surgical interventions. Systematic studies related specifically to the algorithm for choosing the method of fracture fixation and complications have also not been found.

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Minimally invasive plate osteosynthesis for short oblique diaphyseal tibia fractures: does fracture site affect the outcomes?

Cited by 3 publications

References 19 publications

The application of intramedullary nails and transmedullary support screws in surgical treatment of distal tibia fracture

The application of intramedullary nails and transmedullary support screws in surgical treatment of distal tibia fracture

Does a Customized 3D Printing Plate Based on Virtual Reduction Facilitate the Restoration of Original Anatomy in Fractures?

Surgical methods of treatment for tibial diaphyseal fractures

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