Skip Navigation
Skip to contents

KMJ : Kosin Medical Journal

OPEN ACCESS
SEARCH
Search
Advanced Search
mobile menu button

Articles

Page Path
HOME > Kosin Med J > Volume 29(1); 2014 > Article
Original Article
Minimally Invasive Plate Osteosynthesis for Fractures of Distal Tibia
Tae Hun Kim, So Hak Chung
Kosin Medical Journal 2014;29(1):23-29.
DOI: https://doi.org/10.7180/kmj.2014.29.1.23
Published online: December 17, 2014

Department of Orthopedic Surgery, College of Medicine, Kosin University, Busan, Korea

Corresponding Author: So Hak Chung, Department of Orthopaedic Surgery, Kosin University Gospel, Hospital, 34 Amnam-dong, Seo-gu, Busan, 602-702, Korea TEL: +82-51-990-6467 FAX: +82-51-243-0181 E-mail: shchung@kosin.ac.kr
• Received: April 5, 2013   • Revised: October 27, 2013   • Accepted: December 16, 2013

Copyright © 2014 Kosin University School of Medicine Proceedings

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

  • 835 Views
  • 17 Download
Full Article

Download PDF Download PDF

  • Objectives
    This study analyzed clinical and radiologic results, and complications of minimally invasive plate osteosynthesis(MIPO) for distal tibia fracture.
  • Methods
    16 patients (17 cases) who were performed MIPO for distal tibia fractures between January 2007 and June 2011, postoperative followed up at least for one year, were selected for this study. The average age was 55.0(26-76) years old and the average period of followup was 15.1(6-27) months. Most of the patients were encouraged to perform ankle dorsiflexion and straight leg raising exercise on splints, from the next day of the operation. As radiologic evaluation, we checked period until bone union, degree of angulation. And postoperative complications were also checked. For functional evaluation of the ankles, American Orthopaedic Foot and Ankle Society(AOFAS) score was used.
  • Results
    16 of the 17 cases were achieved primary bone union, and average period of bone union in all the cases was 17.4 (12-42) weeks. Mean varus/valgus angulation after the bone union was 0.8 degrees and mean anteroposterior(AP) angulation was 1.8 degrees. Mean AOFAS score was 85.2(71-95) points; 5 cases of excellent, 10 cases of good, 1 case of fair, showing that 93.8% of the patients represented at least good AOFAS scores. As complications, there were 2 cases of superficial infection, and each 1 case of nonunion and skin irritation. There were no cases of deep infection, metal breakage, nor limb length discrepancy.
  • Conclusions
    MIPO for distal tibia fracture is considered to be an effective operative method, because of its high bone union rate and low complications by minimal disruption of soft tissue and improved bone fixation strength. Also, for earlier return to daily life, ankle joint exercise should be started as soon as possible after the operation.
  • Keywords: Distal tibia; Early range-of-motion exercise; Facture; Mimimally invasive plate osteosynthesis (MIPO)
Fig. 1.
(A) A 73 yeared-old woman was sustained distal tibiofibular comminuted fracture by slip down. (B) The distal tibia fracture was stabilized with LCP metaphyseal plate using minimal invasive technique. (C) At 16 weeks postoperatively, radiographs shows bone union.
kmj-29-23f1.jpg
Fig. 2.
(A) A 65-yeared old woman was sustained distal tibiofibular fracture by slip down. (B) The distal tibia fracture was treated with MIPO technique using LCP metaphyseal plate on medial side. (C) At 12 weeks postoperatively, radiograph shows bone union.
kmj-29-23f2.jpg
Table 1.
Patient data
Case Age/Sex Injury mechanism AO/OTA ⋆ classification G-A† classification Union time (week) Ankle‡ score Complication
1 2 62/F SD§ A2 A1 Closed Closed 13 17 86 81 No
3 49/F TA∥ A1 Closed 21 80 Metal irritation
4 37/M TA A2 Type I 42 82 Nonunion
5 30/M TA A1 Type I 17 85 No
6 65/F SD A2 Closed 12 84 No
7 53/M SD A1 Closed 14 91 No
8 50/F SD A1 Closed 17 91 No
9 73/F SD B1 Closed 18 81 No
10 76/M FD A1 Closed 15 88 No
11 26/M FD A1 Closed 12 95 No
12 64/F SD A2 Closed 14 81 No
13 51/M TA A1 Type II 24 71 Skin infection
14 54/F SD A1 Type I 14 92 No
15 48/M SD A1 Closed 13 95 No
16 73/F SD A3 Closed 16 85 No
17 69/M FD A3 Closed 18 81 Skin infection

⋆ AO/OTA: Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association

† G-A: Gustillo-Anderson

‡ Ankle score: ankle-hindfoot functional scale of AOFAS

§ SD: Slip down

∥ TA: Traffic accident

FD: Fall down.

  • 1. Collinge C, Protzman R. Outcomes of minimally invasive plate osteosynthesis for metaphyseal distal tibia fractures. J Orthop Trauma 2010;24:24–9.ArticlePubMed
  • 2. Teeny SM, Wiss DA. Open reduction and internal fixation of tibial plafond fractures. Variables contributing to poor results and complications. Clin Orthop Relat Res 1993;292:108–17.
  • 3. Lau TW, Leung F, Chan CF, Chow SP. Wound complication of minimally invasive plate osteosynthesis in distal tibia fractures. Int Orthop 2008;32:697–703.ArticlePubMed
  • 4. Redfern DJ, Syed SU, Davies SJ. Fractures of the distal tibia: Minimally invasive plate osteosynthesis. Injury 2004;35:615–20.ArticlePubMed
  • 5. Holbrook JL, Swiontkowski MF, Sanders R. Treatment of open fractures of the tibial shaft: Ender nailing versus external fixation. A randomized, prospective comparison. J Bone Joint Surg Am 1989;71:1231–8.PubMed
  • 6. Brumback RJ, McGarvey WC. Fractures of the tibial plafond. Evolving treatment concepts for the pilon fracture. Orthop Clin North Am 1995;26:273–85.PubMed
  • 7. Hasenboehler E, Rikli D, Babst R. Locking compression plate with minimally invasive plate osteosynthesis in diaphyseal and distal tibial fracture: A retrospective study of 32 patients. Injury 2007;38:365–70.ArticlePubMed
  • 8. Borrelli J Jr, Prickett W, Song E, Becker D, Ricci W. Extraosseous blood supply of the tibia and the effects of different plating techniques: A human cadaveric study. J Orthop Trauma 2002;16:691–5.ArticlePubMed
  • 9. Helfet DL, Suk M. Minimally invasive percutaneous plate osteosynthesis of fractures of the distal tibia. Instr Course Lect 2004;53:471–5.PubMed
  • 10. Lee KB. Distal Tibia Fracture. Plate Osteosynthesis. J Korean Fract Soc 2009;22:306–13.Article
  • 11. Kim SK, Lee KB, Lim KY, Moon ES. Minimally invasive osteosynthesis with locking compression plate for distal tibia fractures. J Korean Fract Soc 2011;24:33–40.Article
  • 12. Yoo JS, Park HW. Clinical outcomes of locking compression plate fixation through minimally invasive percutaneous plate osteosynthesis in the treatment of distal tibia fracture. J Korean Fracture Soc 2012;25:117–22.Article
  • 13. Wilber MC, Evans EB. Fractures of the femoral shaft treated surgically. Comparative results of early and delayed operative stabilization. J Bone Joint Surg Am 1978;60:489–91.ArticlePubMed
  • 14. Segal D, Wiss DA, Whitelaw GP. Functional bracing and rehabilitation of ankle fractures. Clin Orthop 1985;199:39–45.Article
  • 15. Vander Griend R, Michelson JD, Bone LB. Instructional course lectures, the american academy of otrhopaedic surgeons. Fractures of the ankle and the distal part of the tibia. J Bone Joint Surg Am 1996;78:1772–83.Article
  • 16. Gul A, Batra S, Mehmood S, Gillham N. Immediate unprotected weight-bearing of operatively treated ankle fracture. Acta Orthop Belg 2007;73:360–5.PubMed
  • 17. Egol KA, Dolan R, Koval KJ. Functional outcome of surgery for fractures of the ankle. A prospective, randomised comparison of management in a cast or a finctional brace. J Bone Joint Surg Br 2000;82:246–9.PubMed
  • 18. Ahmad MA, Sivaraman A, Zia A, Rai A, Patel AD. Percutaneous locking plates for fractures of the distal tibia: Our experience and a review of the literature. J Trauma Acute Care Surg 2012;72:E81–7.PubMed
  • 19. Hazarika S, Chakravarthy J, Cooper J. Minimally invasive locking plate osteosynthesis for fractures of the distal tibia-Results in 20 patients. Injury 2006;37:877–87.ArticlePubMed
  • 20. Hong KD, Ha SS, Chung NS, Sim JC, Ahn SC. Lateral plate fixation of distal tibial metaphyseal fracture using minimally invasive plate osteosynthesis technique. J Korean Fract Soc 2006;19:24–8.Article
  • 21. Shon OJ, Park CH. Minimally invasive plate osteosynthesis of distal tibial fractures: A comparison of medial and lateral plating. J Orthop Sci 2012;17:562–6.ArticlePubMed

Figure & Data

References

    Citations

    Citations to this article as recorded by  

      • PubReader PubReader
      • Cite
        CITE
        export Copy
        Close
      • Download Citation
        Download Citation
        Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
        Format:
        • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
        • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
        Include:
        • Citation for the content below
        Minimally Invasive Plate Osteosynthesis for Fractures of Distal Tibia
        Kosin Med J. 2014;29(1):23-29.   Published online December 17, 2014
        DOI: https://doi.org/10.7180/kmj.2014.29.1.23
        Close
      • XML DownloadXML Download
      Figure
      KMJ : Kosin Medical Journal
      © Kosin University College of Medicine.