Minimally invasive plate osteosynthesis using posterolateral approach for distal tibial and tibial shaft fractures

Yamamoto, Naokatsu; Ogawa, Kenichi; Terada, Chuji; Okazaki, Yuki; Munetomo, Kazuo; Noda, Tomoyuki; Ozaki, Toshifumi

doi:10.1016/j.injury.2016.06.017

Cited by 11 publications

(7 citation statements)

References 12 publications

(18 reference statements)

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“…13 It was also demonstrated in many cases that MIPO has efficacy with less complications in treatment of tibial shaft fracture. 14,15 In the present study, we also demonstrated MIPO was effective in treatment of humeral shaft fractures, with very low rates of nonunion and nerve injury.…”

Section: Discussionsupporting

confidence: 72%

Comparison between Intramedullary Nailing and Minimally Invasive Percutaneous Plate Osteosynthesis in Treatment of Humeral Shaft Fractures

Yuan¹,

Wang²,

Zheng³

et al. 2019

J Coll Physicians Surg Pak

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Section: Discussionsupporting

confidence: 72%

Comparison between Intramedullary Nailing and Minimally Invasive Percutaneous Plate Osteosynthesis in Treatment of Humeral Shaft Fractures

Yuan¹,

Wang²,

Zheng³

et al. 2019

J Coll Physicians Surg Pak

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“…The posterolateral approach to the tibia has been gaining increasing attention as the surgical technique of choice when treating fractures involving the distal tibia (Yamamoto, ). Although the posterolateral approach was initially utilized for bone grafting, it is also currently used in the treatment of Pilon fractures (distal tibial axial fractures) and in the repair of trimalleolar fractures that involve the posterior malleolar fragment of the distal tibia (Assal, ).…”

Section: Introductionmentioning

confidence: 99%

Risk of injury to the sural nerve during posterolateral approach to the distal tibia: An ultrasound simulation study

et al. 2018

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When surgeons operate on the foot and ankle, the most common complication that may arise is injury of the cutaneous nerves. The sural nerve (SN) is potentially at risk of being injured when treating fractures involving the distal tibia using the posterolateral approach. The aim of this study was to evaluate how differences in length and position of the surgical treatment of fractures involving the distal tibia can affect the risk of SN injury. The study involved 40 healthy volunteers (n = 80 lower limbs). Ultrasound simulation of each potential surgical incision site was used to locate the SN and to assess the risk of injury. The study showed that the SN predominantly travels more posteriorly at levels more proximal from the tip of the lateral malleolus. At these more proximal points of the SN's course, it was proven that there was an overall increased incidence of iatrogenic injury to the SN in incisions made closer to the Achilles tendon. Based on these results, a quasi 3 dimensional figure was created showing the anatomical structures of this region to identify areas at high risk for SN injury. By revealing how length and position of the surgical incision can influence the risk of SN injury, we hope to provide information to surgeons on the optimal technique to avoid iatrogenic SN injury while operating on the distal tibia via a posterolateral approach. Clin. Anat. 31:870-877, 2018. © 2018 Wiley Periodicals, Inc.

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“…Surgical treatment of displaced ankle fractures includes anatomic reduction and stable fixation that allows early functional rehabilitation (5,(10)(11)(12)(13)(14)(15)(16) . However, the optimal treatment of the posterior fragment in trimalleolar fractures is still a topic of discussion regarding the diagnostic method, type of treatment, and approach.…”

Section: Discussionmentioning

confidence: 99%

Does the posterior approach offer advantages in short-term in trimalleolar ankle fractures?

Holgado-Fernandez¹,

Galindo-Juárez²,

Muñiz-Zatón³

et al. 2022

J Foot Ankle

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Objective: The aim of this study was to compare the early (nine months after surgery) synthesis of the posterior malleolus by direct posterior (P) approach versus the percutaneous anteroposterior (AP) screw in trimalleolar ankle fractures to analyze the early clinical status of the patient (eight months) by studying the American Orthopedic Foot And Ankle Society (AOFAS) scale to compare postsurgical clinical recovery between both approaches, the rate of hospital days in both groups, the quality of joint reduction by computed tomography (CT) study and the rate of most frequent complications (fibular tendinopathy and surgical wound). Methods: A retrospective comparative study was performed between 2016-2020, including 94 patients with trimalleolar ankle fracture type 44-A/B/C (27 percutaneous AP surgical treatment and 67 P approach). Both groups were compared by analyzing demographic variables, clinical-functional status, radiological variables, and complications. Statistical analysis was performed using SPSS-20, with a p-value of 0.05 as significance. Results: Demographically, both groups were comparable, not finding significant differences between them. An increase in the days of admission before surgery was observed in the P approach with a mean of 4 (p=0.001). No significant clinical differences were found in the AOFAS scale, with a mean of 85 in both groups. Regarding the radiological result, a better reduction was observed with P approach (good=57, fair=9, poor=0) compared to the AP approach (good=10, fair=7, poor=9) (p=0.001). As for the complications, no significant differences were observed for the surgical wound. However, a higher need for fibular plate removal could be observed with P approach (n=17) (p=0.046). Conclusions: Clinically, both groups observed no significant differences through the AOFAS scale. The posterolateral approach has a higher rate of hospital days before surgery. Radiologically, a better joint reduction is achieved by a direct approach to the posterior fragment. Level of Evidence III; Retrospective Comparative Study.

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Minimally invasive plate osteosynthesis using posterolateral approach for distal tibial and tibial shaft fractures

Cited by 11 publications

References 12 publications

Comparison between Intramedullary Nailing and Minimally Invasive Percutaneous Plate Osteosynthesis in Treatment of Humeral Shaft Fractures

Comparison between Intramedullary Nailing and Minimally Invasive Percutaneous Plate Osteosynthesis in Treatment of Humeral Shaft Fractures

Risk of injury to the sural nerve during posterolateral approach to the distal tibia: An ultrasound simulation study

Does the posterior approach offer advantages in short-term in trimalleolar ankle fractures?

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