Open Access, Peer-reviewed, Quarterly
pISSN 1225-1682
eISSN 2287-9293
    J Korean Fract Soc. 2007 Oct;20(4):315-322. Korean.
    Published online Jun 14, 2016.
    https://doi.org/10.12671/jkfs.2007.20.4.315
    Copyright © The Korean Fracture Society. All rights reserved
    Original Article

    Minimally Invasive Percutaneous Plate Osteosynthesis Using Periarticular Plate for Distal Tibial Fractures

    Young Mo Kim, M.D., Jae Hoon Yang, M.D. and Dong Kyu Kim, M.D.
      • Department of Orthopaedic Surgery, Chungnam National University College of Medicine, Daejeon, Korea.
    • Address reprint requests to: Young-Mo Kim, M.D. Department of Orthopaedic Surgery, Chungnam National University College of Medicine, 640, Daesa-dong, Jung-gu, Daejeon 301-721, Korea. Tel: 82-42-280-7352, Fax: 82-42-252-7098, Email: osdr69@cnu.ac.kr

    Abstract

    Purpose

    To evaluate the clinical results of minimally invasive percutaneous plate osteosynthesis using a periarticular plate (Zimmer, Warsaw, IN, USA) for distal tibia fractures.

    Materials and Methods

    27 patients with distal tibia fractures were treated operatively by minimally invasive percutaneous plate osteosynthesis. The patients were followed for at least 1 year. The duration for bone union, complications after the surgery, the amount of skin irritation at the site of plate insertion was evaluated using the VAS score and the Olerud and Molander ankle score. The average age of the patients was 56 years old (range, 30~81 years) with an average follow up period of 21 months (range, 12~30 months).

    Results

    The average time from trauma to surgery was 6 days (range, 2~19 days). 10 cases showed an associated distal fibular fracture. The average time for bone fusion was 14 weeks (range, 8~40 weeks) with 1 case of angular deformity with more than 5 degrees. The amount of skin irritation due to the periarticular plate resulted in a VAS score of 2.2 points. Evaluation of the ankle function test showed an average of 90.2 points, resulting in satisfactory.

    Conclusion

    The periarticular plate used in minimally invasive percutaneous plate osteosynthesis for distal tibia fractures was concluded to give a firm fixation of the fracture site as bony fusion could be acquired without any callus formation, and few skin irritation due to plate has seem to be an advantage.

    Keywords
    Distal tibia; Fracture; Minimally invasive percutaneous plate osteosynthesis (MIPPO); Periarticular plate

    Figures

    Fig. 1
    A 81 year old woman sustained a fracture of right distal tibia after slip down injury.
    (A) A periarticular plate which has at least 4 holes to insert screws above the fractured surface was used.

    (B) The plate was inserted between the periosteum and subcutaneous tissue anteromedially started from the medial malleolus of distal tibia.

    (C) The location and size of plate, and the reduced fracture site was verified by C-arm.

    (D) Percutaneous screw fixation through the medial malleolus of distal tibia region was performed.

    (E) Postoperative radiograph shows satisfactory position of screws.

    Fig. 2
    A 56 year old woman sustained a fracture of right distal tibia after slip down injury.
    (A) Preoperative radiograph show right distal tibia fracture.

    (B) Postoperative radiograph show the periarticular plate fixed on the fracture site.

    (C) Thirty-two week postoperative radiograph after metal removal shows 6° varus angulation deformity.

    Fig. 3
    A 70 year old man sustained a fracture of left distal tibia after traffic accident.
    (A) Preoperative radiograph show left distal tibia fracture.

    (B) Postoperative radiograph after minimally invasive percutaneous internal fixation with periarticular plate.

    (C) The ninety week postoperative radiograph after metal removal shows stable bony union without any callus formation.

    Tables

    Table 1
    Dermographic data of the patients

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    MeSH Terms
    Ankle
    Bony Callus
    Congenital Abnormalities
    Follow-Up Studies
    Humans
    Skin
    Tibia
    Tibial Fractures*
    Metrics
    Share
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