Immediate weightbearing after intramedullary fixation of extra-articular distal tibial fractures reduces the nonunion rate compared with traditional weight-bearing protocol: A cohort study

2020 ◽  
Vol 76 ◽  
pp. 132-135 ◽  
Author(s):  
Shiyang Weng ◽  
Chun Bi ◽  
Song Gu ◽  
Xin Qi ◽  
Yinjun Huang
Keyword(s):  
Cohort Study ◽  
Weight Bearing ◽  
Tibial Fractures ◽  
Intramedullary Fixation ◽  
Distal Tibial Fractures

scholarly journals Distal tibial fracture treated by minimally invasive plate osteosynthesis after external fixation Retrospective clinical and radiographic assessment

2014 ◽  
Vol 20 (1) ◽  
pp. 44-49
Author(s):  
Șerban Al. ◽  
Obadă B. ◽  
Turcu R. ◽  
Anderlik St. ◽  
Botnaru V.
Keyword(s):  
Internal Fixation ◽  
External Fixation ◽  
Ankle Joint ◽  
Plate Osteosynthesis ◽  
Weight Bearing ◽  
Distal Tibia ◽  
Tibial Fractures ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Surgical Trauma ◽  
Distal Tibial Fractures

ABSTRACT Fractures of the horizontal surface of the distal tibia are known commonly as pylon or plafond fractures, and represent 1-5% of lower extremity fractures, 7-10% of all tibial fractures. The protocol consisted of immediate (within eight to 24 hours) open reduction and internal fixation of the fibula, using a fibular plate or one third tubular plate and application of an external fixator spanning the ankle joint. In the second stage, the treatment of proximal and distal tibial fractures with close reduction and MIPPO technique can preserve soft tissue, simplify operative procedure and decrease wound, obtain rigid internal fixation and guarantee early function exercises of ankle joint. In this study we evaluated 22 patients treated in Clinical Emergency Hospital Constanta between April 2012 - July 2013 diagnosed with multifragmentary fractures of the distal tibia. This study evaluates the treatment of complex fractures of distal tibia with locked plate after external fixation. There were 17 males and 5 females of mean age 51,7 years (31-68). The mean follow-up period was 14 weeks. (Ranging from 9-16 weeks). All patients were fully weight bearing at 16 weeks (ranging 9-16 weeks) showing radiological union. There were no cases of failures of fixation, or rotational misalignment. No significant complication was observed in our patients. MIPO is an effective method of treatment for distal tibial fractures, reduce surgical trauma and maintain a more biologically favorable environment for fracture healing, reducing risks of infection and nonunion.

scholarly journals Minimally Invasive Percutaneous Plate Osteosynthesis Does Not Increase Complication Rates in Extra-Articular Distal Tibial Fractures

2015 ◽  
Vol 9 (1) ◽  
pp. 73-77 ◽  
Author(s):  
Izzet Bingol ◽  
Nadir Yalcin ◽  
Vedat Bicici ◽  
Tolga Tulunay ◽  
Kaan Yuksel ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Soft Tissues ◽  
Callus Formation ◽  
Plate Osteosynthesis ◽  
Weight Bearing ◽  
Cohort Analysis ◽  
Tibial Fractures ◽  
Full Weight Bearing ◽  
Complication Rates ◽  
Distal Tibial Fractures

Background : Selection of a treatment method in cases of unstable, nonarticular distal tibial fractures is still a matter of discussion. Intramedullary nailing, which is a “gold standard” for tibial shaft fractures, does not always work for this specific transition area between diaphysis and metaphysis. Instead, new minimally invasive techniques with special implants are popular. Aims : To determine the functional and radiological results of distal tibial fractures treated with minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. Study Design : Retrospective cohort analysis. Methods : Thirty distal tibial fractures treated with MIPPO method, between January 2006 and December 2010, were evaluated retrospectively. All patients were classified according to AO/OTA classification. Period of hospital stay, time of fracture union, time to allow full weight bearing, early and late complications were inquired. Functional outcomes were assessed by AOFAS scores. Results : There were 13 male and 17 female patients with an average age of 44.26 (range, 22-77 years). One superficial infection and one malunion were observed. Two patients were revised for the loss of reduction and healed uneventfully. According to the AO/OTA classification, 23 patients were 43-A1 (76.6%), 3 were 43-A2 (10%) and 4 were 43-A3 (13.3%). Post-operative mean stay of patients at the hospital was 2.6 ± 1.42 days (range, 1-7 days). Mean full weight-bearing period of the patients was found out as 13.16 ± 2.6 weeks (range, 10-22 weeks). The mean period of union of fracture for patients was found out as 19.8 ± 2.99 weeks (range, 16-34 weeks). Conclusion : Treatment of distal tibial fractures with MIPPO method provides a successful treatment strategy as long as used as per the technique, and it respects and does not harm soft tissues which allows early callus formation and rapid healing that enable the patient to walk as early as possible after the operation. The overall clinical and functional outcome is still good despite minor complications.

scholarly journals Nail or plate in the management of distal extra-articular tibial fracture, what is better? Valutation of outcomes

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 2 ◽  
Author(s):  
Michele Bisaccia ◽  
Andrea Cappiello ◽  
Luigi Meccariello ◽  
Giuseppe Rinonapoli ◽  
Gabriele Falzarano ◽  
...  
Keyword(s):  
Bone Fractures ◽  
Weight Bearing ◽  
Excellent Result ◽  
Operation Time ◽  
Tibial Fractures ◽  
Long Bone ◽  
Full Weight Bearing ◽  
Distal Tibial Fractures ◽  
Study Results ◽  
The Mean

Introduction: Distal tibial fractures are the most common long bone fractures. Several studies focusing on the methods of treatment of displaced distal tibial fractures have been published. To date, locked plates, intramedullary nails and external fixation are the three most used techniques. The aim of our study was to compare intramedullary nail (IMN) and locked plate (LP) for treatment of this kind of fracture. Materials and methods: We collected data on 81 patients with distal tibial fractures (distance from the joint between 40 and 100 mm) and we divided into two groups: IMN and LP. We compared in the 2 groups the mean operation time, the mean union time, the infection rate the rate of malunion and nonunion, the full weight bearing time. Results: No patient in the two groups developed a nonunion. None of the patients obtained a fair or poor outcome. Overall 52 patients obtained an excellent result (69.3%) and 23 obtained a good result (30.6%). Discussion: Our study results indicate a superiority of IMN over LP in terms of lower rates of infections and statistically significant shorter time to full weight bearing. Whereas LP appeared to be advantageous over IMN in terms of leading to a better anatomical and fixed reductions of the fracture and a lower rate of union complications. The two treatments achieved comparable results in terms of operation time, hospital stay, union time and functional outcomes.

scholarly journals Comparison Between Nailing and Plating in the Treatment of Distal Tibial Fractures: A Meta-Analysis

2020 ◽  
pp. 145749692095783
Author(s):  
E. Ekman ◽  
K. Lehtimäki ◽  
J. Syvänen ◽  
M. Saltychev
Keyword(s):  
Confidence Interval ◽  
Risk Ratio ◽  
Intramedullary Nail ◽  
Plate Fixation ◽  
Meta Analysis ◽  
Weight Bearing ◽  
Tibial Fractures ◽  
Controlled Trials ◽  
Complication Rates ◽  
Distal Tibial Fractures

Background and Aims: To evaluate evidence on the superiority of plate fixation over intramedullary nail fixation in the treatment of distal tibial fractures regarding functional outcomes and complication rates. Material and Methods: Cochrane Controlled Trials Register, Medline, Embase, CINAHL, Scopus, and Web of Science databases were searched in December 2019. The risk of systematic bias was assessed according to the Cochrane Collaboration’s domain-based evaluation framework. Results: The search resulted in 514 records, the final sample included 10 randomized controlled trials (782 patients). There were statistically significant differences in operating time (−11.2, 95% confidence interval: −16.3 to −6.1 min), time to partial weight bearing (−0.96, 95% confidence interval: −1.8 to −0.1 weeks), time to full weight bearing (−2.2, 95% confidence interval: −4.32 to −0.01 weeks), the rates of deep infections (risk ratio = 0.37, 95% confidence interval: 0.19 to 0.69), and the rates of soft-tissue complications (risk ratio = 0.52, 95% confidence interval: 0.33 to 0.82) favoring intramedullary nail. Intraoperative blood loss (127.2, 95% confidence interval: 34.7 to 219.7 mL) and postoperative knee pain and stiffness (relative risk = 5.6, 95% confidence interval: 1.4–22.6) showed significant differences favoring plate fixation. When combining all complication rates, the difference was risk ratio = 0.77 (95% confidence interval: 0.63 to 0.95) favoring intramedullary nail. No significant differences in radiation time, length of incision, length of hospital stay, time to return to work, time to union, the rates of healing complications or secondary procedures, ankle pain or stiffness, or functional scores were found. Conclusion: This meta-analysis suggests that intramedullary nail might be slightly superior in reducing postoperative complications and result in slightly faster healing when compared to plate fixation.

scholarly journals Biomechanical comparison of different cerclage types in addition to an angle stable plate osteosynthesis of distal tibial fractures

Injury ◽  
2021 ◽  
Author(s):  
Stefan Förch ◽  
Sabrina Sandriesser ◽  
Edgar Mayr ◽  
Falk Schrödl ◽  
Christian von Rüden ◽  
...  
Keyword(s):  
Plate Osteosynthesis ◽  
Tibial Fractures ◽  
Distal Tibial Fractures ◽  
Angle Stable ◽  
Biomechanical Comparison ◽  
Angle Stable Plate
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