Outcome of Minimal Invasive Percutaneous Plate Osteosynthesis in closed fractures of distal tibia

Abstract

Background Treatment of fracture distal tibia is challenging. Classic open reduction and internal plate fixation requires extensive soft tissue dissection and causes periosteal injury. The locking screw-plate interface allows fracture fixation without plate-bone adherence, thus preserving the fracture hematoma, and reduces the risk of nonunion by maintaining microvascular circulation within the cortex and its investing tissues. Material & Methods This study included 33 patients of age between 18 to 62 years with extra-articular and simple intra-articular fracture of distal tibia. All fractures were fixed by minimally invasive technique with pre-countered distal tibia locking plate under image intensifier control. The American Orthopaedic Foot and Ankle Society (AOFAS) scale was used for functional assessment. Results Out of 33 there were twelve 43-A1, five A2, five A3, five B1, three B2, two C, one C2 fractures. There were 29 closed fracture and four open fracture (three type I and one type II). The overall mean time of union was 16.3 weeks. The mean AOFAS score was 93 points. In all 30 cases there were no wound problems, whereas three cases had superficial wound infection. No any cases needed secondary procedure for healing of bone. Conclusion The short-term results shows that minimally invasive locked plating is good solution for the challenging distal tibia fracture. This technique minimizes soft tissue complication and provides good union and functional outcome.

The Outcome of Pediatric Femur Fractures Fixation with Titanium Elastic Nail System

“…The periosteum is not disturbed, and being a closed procedure, there is no disturbance of the fracture hematoma, thereby having less risk of infection. 28,30 by 78.72. % (37 cases) vs. 21.27% (10 cases) with boy to girl ratio of 3.7:1.…”

“…12 Another study in Nepal by Mishra et al reported excellent results in 80 % and good results in the remaining 20% with no poor results. 28 Fracture geometry and location are essential determinants for surgical outcomes. In our study, TENS gave excellent results in transverse and short oblique fractures.…”

Randomized controlled trial comparing outcome of hybrid Ilizarov versus distal tibial metaphyseal locking plate (P) for treatment of distal tibial fractures in adults

“…The clinico-radiological union rates at 12 weeks were 82.5 % for HI group and 90 % for P group. Previous study has shown average healing time to be 12-15 weeks in P. 23,25 While some studies have shown average union time in P to be 19 weeks and for HI to be 21 weeks. 20 Previous studies have reported satisfactory union rates when using the external fixation strategy as a definitive method of treatment in cases of tibial plafond fractures.…”