Anatomical pre-contoured plates in management of distal tibia fracture: a prospective study

Authors

  • Jayanta K. Laik Department of Joint Replacement and Orthopaedics, TATA Main Hospital, Jamshedpur, Jharkhand, India
  • Nishant K. Niraj Department of Joint Replacement and Orthopaedics, TATA Main Hospital, Jamshedpur, Jharkhand, India; Department of Orthopaedics, Manipal Tata Medical College, MAHE, Jamshedpur, Jharkhand, India
  • Ravi Kaushal Department of Joint Replacement and Orthopaedics, TATA Main Hospital, Jamshedpur, Jharkhand, India; Department of Orthopaedics, Manipal Tata Medical College, MAHE, Jamshedpur, Jharkhand, India https://orcid.org/0000-0002-8748-6116
  • Ritesh Kumar Department of Joint Replacement and Orthopaedics, TATA Main Hospital, Jamshedpur, Jharkhand, India; Department of Orthopaedics, Manipal Tata Medical College, MAHE, Jamshedpur, Jharkhand, India
  • Somit Sarkar Department of Joint Replacement and Orthopaedics, TATA Main Hospital, Jamshedpur, Jharkhand, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20233263

Keywords:

Distal tibia fracture, MIPPO, AOFAS, Precontoured plate, Anatomical plate

Abstract

Background: Distal tibial fractures are complex injuries with high complication rate. Management of such fractures are often complicated by soft tissue injuries. Precarious vascularity around distal tibia also results in high non-union rates. This study aims to study and analyse the outcome of distal tibia fracture managed by anatomical contoured plate.

Methods: In this prospective observational study, we attempted to assess the functional and radiological outcome of distal tibia fracture managed by with distal tibia fracture with average follow up of 24 weeks. ORIF/MIPO with plating was done for fracture distal tibia with anatomical precontoured plates.

Results: Patients were evaluated using AOFAS and measure of ankle range of motion. Average functional score was 88 with complications in 3 patients.

Conclusions: We believe precontoured plates provide for better biological fixation than conventional plates.

References

Al Șerban. Distal tibial fracture treated by minimally invasive plate osteosynthesis after external fixation Retrospective clinical and radiographic assessment. ARS Medica Tomitana. 2014;20(1):44-9.

Sohn HS, Oh JK, Yang HS, Kim HR. Anatomically Precontoured Locked Plates in Pilon Fractures: A Computed Tomography Based and Cadaveric Study. Indian J Orthop. 2018;52(6):665-71.

Ballal A, Rai HR, Shetty SM, Mathias LJ, Shetty V, Shetty A. A Prospective Study on Functional Outcome of Internal Fixation of Tibial Pilon Fractures with Locking Plate using Minimally Invasive Plate Osteosynthesis Technique. J Clin Diagn Res. 2016;10(1):RC01-4.

Pandey BK, Manandhar RR, Sharma S, Pradhan RL, Lakhey S, Rijal KP. Conservative treatment of nonarticular fractures of distal third tibia. JNMA J Nepal Med Assoc. 2009;48(176):292-5.

Kumar RJ, Manjappa DH. A prospective study of surgical management of distal tibial fractures treated with minimally invasive percutaneous plate osteosynthesis using locking compression plate. Int J Res Orthop. 2017;3(3):545-50.

Sarmiento A, Latta L. 450 Closed fractures of distal tibia treated with a functional brace. Clin Orthop Relat Res. 2004;(428):261-71.

Bahari S, Lenehan B, Khan H, McElwain J. Minimally invasive percutaneous plate fixation of distal tibia fractures. Acta Orthop Belg. 2007;73:635-40.

Nguyen LV, Nguyen GN, Nguyen BL, Bui HM. Results and complications of minimally invasive medial plate osteosynthesis for distal metaphyseal tibial fractures: A prospective case series from Vietnam. Ann Med Surg. 2021;70:102886.

Blauth M, Bastian L, Krettek C, Knop C, Evans S. Surgical options for the treatment of severe tibial pilon fractures: a study of three techniques. J Orthop Trauma. 2001;15:153-60.

Copin G, Nérot C. Recent fractures of the tibial pilon in adult (Symposium du 66ème Congrès de la SOFCOT). Rev Chir Orthop. 1992;78(Suppl-1):3-83.

Bihani M, Sravanth KP, Sharma S, Sood R, Fahad BH. Intramedullary fixation of distal tibial fractures around diametaphysis using locked intramedullary cannulated distal tibial nail a prospective study. Int J Orthop Sci. 2016;2:38-42.

Stannard JP, Finkemeier CG, Lee J, Kregor PJ. Utilization of the less-invasive stabilization system internal fixator for open fractures of the proximal tibia: a multi-center evaluation. Indian J Orthop. 2008;42(4):426-30.

Ronga M, Longo UG, Maffulli N. Minimally invasive locked plating of distal tibia fractures is safe and effective. Clin Orthop Relat Res. 2010;468:975-82.

Field J, Hearn T, Caldwell C. Bone plate fixation: an evaluation of interface contact area and force of the dynamic compression plate (LC-DCP) applied to cadaveric bone. J Orthop Trauma. 1997;11:368-73.

Brown CC, Walker C, Garg A. Half ring external fixation in the management of tibial plafond fractures. J Orthop Trauma. 1999;13(3):200-6.

Fan C, Chiang C, Chuang T, Chiu F, Chen T. Interlocking nailing for displaced metaphyseal fractures of the distal tibia. Injury. 2005;36:669-74.

Ruedi TP, Allgower M. Fractures of the lower end of the tibia into the ankle joint. Injury. 1969;1(2):92-9.

Egol K, Kubiak E, Fulkerson E, Kummer F, Koval K. Biomechanics of locked plates and screws. J Orthop Trauma. 2004;18:488-93.

Apivatthakakul T, Phornphutkul C, Patumasutra S. Idea and innovation: Simple minimally invasive plate osteosynthesis (MIPO) instruments. Injury Extra. 2009;40:39-44.

Joveniaux P, Ohl X, Harisboure A, Berrichi A, Labatut L, Simon P, et al. Distal tibia fractures: management and complications of 101 cases. Inter Orthop. 2010;34:583-8.

Vallier HA, Le TT, Bedi A. Radiographic and clinical comparisons of distal tibia shaft fractures (4 to 11 cm proximal to the plafond): plating versus intramedullary nailing. J Orthop Trauma. 2008;22:307-11.

Yang SW, Tzeng HM, Chou YJ, Teng HP, Liu HH, Wong CY. Treatment of distal tibial metaphyseal fractures: Plating versus shortened intramedullary nailing. Injury. 2006;37:531-5.

Guo JJ, Tang N, Yang HL, Tang TS. A prospective, randomised trial comparing closed intramedullary nailing with percutaneous plating in the treatment of distal metaphyseal fractures of the tibia. J Bone Joint Surg Br. 2010;92-B:984-8.

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.

Borrelli J, Prickett W, Song E, Becker D, Ricci W. Extra osseous blood supply of the distal tibia and the effects of different plating techniques: Human cadaveric study. J Orthop Trauma. 2002;16:691-5.

Ronga M, Longo UG, Maffulli N. Minimally invasive locked plating of distal tibia fractures is safe and effective. Clin Orthop Relat Res. 2010;468:975-82.

Mushtaq A, Shahid R, Asif M, Maqsood M. Distal tibial fracture fixation with locking compression plate (LCP) using the minimally invasive percutaneous osteosynthesis (MIPO) technique. Eur J Trauma Emerg Surg. 2009;35:159-64.

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.

Bahari S, Lenehan B, Khan H, Mcelwain JP. Minimally invasive percutaneous plate fixation of distal tibia fractures. Acta Orthop Belg. 2007;73:635-40.

Lau TW, Leung F, Chan CF, Chow SP. Wound complication of minimally invasive plate osteosynthesis in distal tibia fractures. Inter Orthop. 2008;32:697-703.

Shrestha D, Acharya BM, Shrestha PM. Minimally invasive plate osteosynthesis with locking compression plate for distal diametaphyseal tibia fracture. Kathmandu Univ Med J. 2011;34(2):62-8.

Gupta RK, Rohilla RK, Sangwan K, Singh V, Walia S. Locking plate fixation in distal metaphyseal tibial fractures: series of 79 patients. Inter Orthop. 2010;34:1285-90.

Guo J, Tang N, Yang H, Tang T. A prospective, randomized trial comparing closed inramedullary nailing with percutaneous plating in thetreatment of distal metaphyseal fractures of the tibia. J Bone Joint Surg Surg Br. 2010;92(7):984-8.

Li A, Wei Z, Ding H, Tang H, Liu Y, Shi J, et al. Minimally invasive percutaneous plates versus conventional fixation techniques for distal tibial fractures: A meta-analysis. Int J Surg (London, England). 2017;38:52-60.

Collinge C, Protzman R. Outcomes of minimally invasive plate osteosynthesis for metaphyseal distal tibia fractures. J Orthop Trauma. 2010;24:24-9.

Hasani I, Kaftandziev I, Stojmenski S, Trpeski S, Kostov H, Nikolov L, et al. Two Stage Minimally Invasive Method with Locking Plate Application on Distal Tibia Fractures - Our Experience. Open Access Maced J Med Sci. 2017;5(5):630-4.

Downloads

Published

2023-10-26

Issue

Section

Original Research Articles