Minimally-invasive plate osteosynthesis in distal tibial fractures: Results and complications

Vidović, Dinko; Matejčić, Aljoša; Ivica, Mihovil; Jurišić, Darko; Elabjer, Esmat; Bakota, Bore

doi:10.1016/j.injury.2015.10.067

Cited by 62 publications

(54 citation statements)

References 26 publications

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“…Some studies noted that the stiff construct did not facilitate adequate callus formation because of inadequate motion [9]. Moreover, some other reports revealed that bridging fixation by a locking plate for simple tibia fracture can lead to delayed union and suggested fixation of absolute stability [5][6]. Wenger and his colleagues [22] compared absolute stability with relative stability for simple distal tibia fracture by MIPO, and found that the median time to radiological was 19 weeks in the absolute fixation group and 27 weeks in the bridge plating group.…”

Section: Discussionmentioning

confidence: 99%

“…To protect the blood supply and provide durable stabilization, the bridge technique with a locking plate by minimally invasive plate osteosynthesis was extensively adopted. Numerous researches identified the advantage of this plating technique for distal distal-third tibia fractures; however, trials have observed the increased rate of prolonged healing for simple distal tibia fractures [5][6], thereby indicating the limitation of the locking plate for simple distal distal-third tibia fractures. A few studies revealed that locked plating constructs provided overly rigid fixation and inhibited micromotion at the fracture site, which may suppressed callus formation, resulting in delayed union, nonunion, and fixation failure [7][8][9][10].…”

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confidence: 99%

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Clinical effects of dynamic stabilization with far cortical locking system in the treatment of simple distal-third tibia fractures: A cohort study

Jing

Fan

et al. 2020

Preprint

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Background: Locked plating constructs provided rigid fixation and may suppress callus formation at the fracture site, while far cortical locking (FCL) constructs have been shown to reduce the stiffness, thereby promoting fracture healing. A few publications have demonstrated that FCL construct increased axial dynamization and improved fracture healing. However, it is unclear whether the FCL construct was superior over locked plating construct for treating simple tibia fractures. Thus, we aimed to compare the clinical effect of FCL construct and locked plating construct for these fracture types.Methods: We retrospectively analyzed 18 patients treated with locked plating (control group) and 22 patients treated with the FCL construct (FCL group) from January 2016 to January 2018; the simple distal-third tibia fractures were included (AO/OTA classification: 42A1-A3 or 43A1). Patients were followed up regularly at 1, 2, 3, 6, and 12 months postoperatively, and data from clinical and radiological examinations were obtained. Patients’ demographics, operative time, time to radiological fracture union, time to full weight bearing, callus index, radiographic union score in tibia (RUST), and surgery-related complications were analyzed between the two groups.Results: The baseline patients’ demographics were similar between the two groups (P>0.05). There were no significant differences in of the operative time, time to radiological fracture union, or time to full weight bearing (P>0.05). However, the median callus index was 1.15 (IQR=1.08–1.25) in the FCL group and 1.09 (IQR=1.00–1.14) in the control group, showing a significant difference between the two groups (Z=-2.35, P<0.05), and the RUST was significantly higher at 2 months postoperatively (6.50±0.92 vs 7.59±1.37, P =0.006). Seven out of 18 patients in the control group and 2 out of 22 patients in the FCL group had no callus formation (callus index=1.0). All patients ultimately healed, and the complication rates were similar between the two groups.Conclusions : The FCL construct could promote fracture healing and was superior to locked bridge plating, as it did not lead to more surgery-related complications. Level of Evidence : Ⅲ, retrospective cohort study

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Clinical effects of dynamic stabilization with far cortical locking system in the treatment of simple distal-third tibia fractures: A cohort study

Jing

Fan

et al. 2020

Preprint

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“…'nın (15) Borrelli ve ark. 'nın (17) yaptığı kadavra çalışmasında, (16) . Çalışmamızda, her iki grupta yapılan ameliyatlarda kırık hattı açılmadığı ve mini insizyonlarla yapıldığı için belirgin bir kan kaybına rastlanmadı.…”

Section: Discussionunclassified

A comparison of minimally invasive anatomic plate and LRS external fixator in extraarticular distal tibia fractures

Tekin¹,

İmren²,

Çabuk³

et al. 2017

IKSST

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“…Minimally invasive fixation includes percutaneous plate osteosynthesis, closed reduction and internal fixation with percutaneous cannulated screws, and arthroscopy-assisted reduction and internal fixation with percutaneous screws (Stasikelis et al 1993; Müller and Sommer 2012; Puha et al 2012; Tong et al 2012; Ortmaier et al 2015). Paluvadi et al (2014) and Vidovic et al (2015) used MIPO to treat distal tibial fractures, and reported good outcomes. Syed and Panchbhavi (2004) treated 7 patients with closed pilon fractures by using closed reduction and internal fixation with percutaneous cannulated screws, and reported excellent outcomes.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive treatment of tibial pilon fractures through arthroscopy and external fixator-assisted reduction

et al. 2016

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ObjectiveThe aim of this study was to evaluate the clinical outcome of tibial pilon fractures treated with arthroscopy and assisted reduction with an external fixator.MethodsThirteen patients with tibial pilon fractures underwent assisted reduction for limited lower internal fixation with an external fixator under arthroscopic guidance. The weight-bearing time was decided on the basis of repeat radiography of the tibia 3 months after surgery. Postoperative ankle function was evaluated according to the Mazur scoring system.Results Healing of fractures was achieved in all cases, with no complications such as severe infection, skin necrosis, or an exposed plate. There were 9 excellent, 2 good, and 2 poor outcomes, scored according to the Mazur system. The acceptance rate was 85%.ConclusionArthroscopy and external fixator-assisted reduction for the minimally invasive treatment of tibial pilon fractures not only produced less trauma but also protected the soft tissues and blood supply surrounding the fractures. External fixation could indirectly provide reduction and effective operative space for arthroscopic implantation, especially for AO type B fractures and partial AO type C1 fractures.

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Minimally-invasive plate osteosynthesis in distal tibial fractures: Results and complications

Cited by 62 publications

References 26 publications

Clinical effects of dynamic stabilization with far cortical locking system in the treatment of simple distal-third tibia fractures: A cohort study

Clinical effects of dynamic stabilization with far cortical locking system in the treatment of simple distal-third tibia fractures: A cohort study

A comparison of minimally invasive anatomic plate and LRS external fixator in extraarticular distal tibia fractures

Minimally invasive treatment of tibial pilon fractures through arthroscopy and external fixator-assisted reduction

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