scholarly journals Locking versus Non-locking Neutralization Plates with Limited Excision and Internal Fixation for Treatment of Extra-articular Type a Distal Tibial Fractures

2017 ◽  
Vol 11 (1) ◽  
pp. 57-63
Author(s):  
Kai-hua Zhou ◽  
Nong Chen
Keyword(s):  
Locking Plate ◽  
Type A ◽  
Tibial Fractures ◽  
Locking Plates ◽  
Superficial Infection ◽  
Distal Tibial Fractures ◽  
Radiographic Outcomes ◽  
Plate Group ◽  
The Cost

Purpose: This study aimed to compare the clinical, radiologic, and cost-effectiveness results between locking and non-locking plates for the treatment of extra-articular type A distal tibial fractures. Methods: We performed a retrospective review of AO/OTA 42-A1, A2 distal tibial fractures treated by plates from January 2011 to June 2013. Patients were divided to the locking plate group or the non-locking plate group. Clinical outcomes, radiographic outcomes, and hospitalization fee were compared between the two plates groups. Results: 28 patients were treated with a locking plate and 23 patients were treated with a non-locking plate. The mean follow-up was 18.8 months (12-23 months). There were no significant differences between the groups in surgical time, bleeding, bone union time, or AOFAS scores. The cost of the locking plate was ¥24,648.41 ± 6,812.95 and the cost of the non-locking plate was ¥11,642 ± 3,162.57, p < 0.001. Each group had one patient that experienced superficial infection these wounds were readily healed by oral antibiotics and dressing changes. To date, five patients in the locking group and ten patients in the non-locking group had sensations of metal stimulation or other discomfort (X2 = 3.99, p < 0.05) Until the last follow-up, 14 patients in the locking plate group and 18 patients in the non-locking plate group had their plates removed or wanted to remove their plates (X2 = 4.31, p < 0.05). Conclusion: The use of locking or non-locking plates provides a similar outcome in the treatment of distal fractures. However the locking plate is much more expensive than the non-locking plate.

scholarly journals Blocking Pins Instead of Blocking Screws in the Treatment of Distal Tibial Fractures with Intramedullary Nail

2020 ◽  
Author(s):  
Xiaodong Bai ◽  
Zhaohui Song ◽  
Shuangquan Yao ◽  
Song Liu ◽  
Lijie Ma ◽  
...  
Keyword(s):  
Sagittal Plane ◽  
Healing Process ◽  
Operating Time ◽  
Tibial Fractures ◽  
Controlled Study ◽  
Intramedullary Nails ◽  
Distal Tibial Fractures ◽  
Radiographic Outcomes ◽  
Average Change

Abstract Background: Distal tibial fractures have a high risk of malalignment when treated with intramedullary nails. The use of blocking screws can aid in achieving satisfactory alignment. The aim of this study was to compare the clinical and radiographic outcomes of temporary blocking pins with those of blocking screws for distal tibial fractures. Methods: From June 2011 through November 2018, a total of 90 patients with distal tibial fractures were enrolled in this prospective randomized controlled study. The patients were randomly received either blocking pins or blocking screws reduction during nailing. After reduction, 5 points at the distal fragment were effectively fixed. Results: The operating time in the BP group was 73.77±6.25 min, which was significantly shorter than 80.05±8.51 min in the BS group (P<0.001). The time to healing in the BP group was shorter than that in the BS group (18.52±4.57 vs. 21.51±3.17 weeks; P=0.001). The coronal and sagittal plane deformities at any time points were comparable (all P＞0.05). During the 12-month follow-up period, patients had an average change in the coronal plane of 1.34 degrees in the BP group and 1.00 degrees in the BS group (P=0.120), as well as an average change in the sagittal plane of 1.09 degrees and 0.81 degrees (P=0.110), respectively. Malunion was seen in two patients (5%) in the BP group and one patient (2%) in the BS group ( P＞0.05). Conclusion: The blocking pins can help achieve satisfactory alignment for distal tibial fractures during nailing. Intramedullary nails without blocking screws can afford adequate stability to maintain the reduction during the healing process when an effective five-point anchoring fixation is achieved.

scholarly journals Open reduction and internal fixation of volar Barton’s fractures by polyaxial locking plates: a retrospective study

2019 ◽  
Vol 5 (5) ◽  
pp. 800
Author(s):  
Angatha Kumar Murugesan ◽  
Rajesh Govindasamy ◽  
Patel Yahya Ismail
Keyword(s):  
Tendon Rupture ◽  
Locking Plate ◽  
Extensor Tendon ◽  
Complication Rates ◽  
Locking Plates ◽  
Compression Injury ◽  
Locked Plate ◽  
Superficial Infection ◽  
One Year

<p class="abstract"><strong>Background:</strong> A Barton’s fracture is a compression injury with a marginal shearing fracture of the distal radius. Conservative management of these fractures are highly unsuccessful with multiple complications. Locked plate and screw systems acts as single unit for fracture fixation, allows early mobilisation with good functional recovery.The objective of the study is to evaluate the functional and radiological outcome of volar Barton’s fractures treated with polyaxial locking plates.</p><p class="abstract"><strong>Methods:</strong> Thirty six patients with volar Barton’s fractures, who underwent surgical treatment with polyaxial locking plate between June 2014 to June 2018, with a minimum one year of follow up. The fractures were classified according to Mehara’s classification and the outcome was evaluated using Pattee and Thompson criteria for outcome of wrist.<strong></strong></p><p class="abstract"><strong>Results:</strong> We achieved 100 % union in all patients. Our results were excellent (61%), good (28%) and fair (11%). Our complications include superficial infection, finger stiffness, radiocarpal arthritis, extensor tendon rupture and Sudeck’s osteodystrophy.</p><p class="abstract"><strong>Conclusions:</strong> Polyaxial locking plates restore articular congruity of the volar Barton’s fracturess and give best possible results with least complication rates, provided the technique is carefully performed.</p>

scholarly journals Evaluation of Outcome of Management of Distal Tibial Fractures using Distal Tibial Locking Plate

2017 ◽  
Vol 4 (1) ◽  
pp. 5-9
Author(s):  
Rajesh Kapila ◽  
Mannan Ahmed ◽  
Radhe S Garg ◽  
Sanjeev Jindal ◽  
Vivek Bansal
Keyword(s):  
Tibial Fracture ◽  
Locking Plate ◽  
Tibial Fractures ◽  
Asia Pacific ◽  
Modern Trend ◽  
Rigid Fixation ◽  
Locking Plates ◽  
Distal Tibial Fracture ◽  
Distal Tibial Fractures ◽  
Articular Fractures

ABSTRACT Aim The modern trend in the management of fractures is fast changing in favor of rigid fixation and early mobilization with minimal period of plaster immobilization. We present a prospective cohort study of fixation of distal tibial fractures with distal tibial locking plate and its evaluation in terms of maintenance of accurate anatomical reduction, stable fixation, with early restoration of functions. Materials and methods A total of 25 patients with median age 38.04 years, age range 19 to 70, with distal tibial fracture were treated by using distal tibial locking plate. The outcome was evaluated using American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. Results The majority of fractures in this study were extraarticular (64%), while 20% were partial articular fractures and 16% were complete articular fractures. Out of 25 patients, 6 patients had superficial infection and 1 patient had deep infection. Out of 25 cases, 5 cases had union by 16 weeks, 11 cases by 20 weeks, 7 cases had union by 30 weeks, and 2 cases had nonunion. According to AOFAS score at 6 months, 4 cases had score of 31 to 70 and 21 cases had score of 71 to 100. Conclusion The results of our study corroborate with the contemporary literature relevant to distal tibial fracture fixation performed with various locking plates. Therefore, locking compression plate is a good device to stabilize the fracture of the distal tibial. Clinical significance Locking plates are a good device to stabilize the fractures of the distal tibial, especially when used in conjunction with meticulous intraoperative handling of soft tissue and active participation of patients in rehabilitation program. Studying this alternative method expands the present knowledge for the management of distal tibial fractures. How to cite this article Ahmed M, Jindal S, Bansal V, Kapila R, Garg RS. Evaluation of Outcome of Management of Distal Tibial Fractures using Distal Tibial Locking Plate. J Foot Ankle Surg (Asia-Pacific) 2017;4(1):5-9.

scholarly journals Associations Between the Fracture Type and Functional Outcomes After Distal Radial Fractures Treated With a Volar Locking Plate

Medicina ◽  
2013 ◽  
Vol 49 (9) ◽  
pp. 62
Author(s):  
Kęstutis Braziulis ◽  
Rytis Rimdeika ◽  
Rima Kregždytė ◽  
Šarūnas Tarasevičius
Keyword(s):  
Locking Plate ◽  
Hand Function ◽  
Linear Regression Analysis ◽  
Type A ◽  
Dash Score ◽  
Volar Locking Plate ◽  
Fracture Type ◽  
Type C ◽  
And Gender

Objective. The aim of this study to investigate the associations of fracture type, age, and gender with hand function after distal radius fractures treated with a volar locking plate at a 6-month follow-up. Material and Methods. A total of 120 patients with displaced distal radius fractures were included into the study. They were operated on using a volar locking plate system. All the fractures were classified according to the AO classification, and the patients were divided into 3 groups by the fracture type. The range of motion and grip strength were evaluated at the 6-month follow-up. Multivariate linear regression analysis was used to evaluate the associations of age, gender, and fracture type with the score of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. The DASH questionnaire was completed as an outcome measure. Results. A total of 28 patients experienced type A fractures; 70 patients, type B fractures; and 22 patients, type C fractures. No statistically significant difference regarding age and sex among the groups was observed. At 6 months after the surgery, the mean DASH score for type A, B, and C fractures was 16, 13, and 32, respectively (P=0.01). After the surgery, the radiographic parameters such as the volar tilt and the ulnar variance were significantly worse in the patients with type C fractures. Grip strength and the range of motion of the contralateral healthy hand at the 6-month follow-up were significantly better than those of the operated hand. The linear regression analysis showed that the type C fracture was the only factor significantly associated with lower DASH score. Conclusions. The patients with type C fractures treated with a volar locking plate had a worse wrist function as compared with the patients type A and B fractures at the 6-month follow-up. The postoperative hand function was significantly associated only with the type C fracture, while age and gender had no significant impact.

Procedure-Specific Hardware Removal After Evans Osteotomy

2020 ◽  
Vol 110 (2) ◽  
Author(s):  
Patrick A. DeHeer ◽  
Shrunjay Patel ◽  
Sarah N. Standish
Keyword(s):  
Pain Relief ◽  
Locking Plate ◽  
Hardware Removal ◽  
Significant Finding ◽  
Locking Plates ◽  
Inclusion Criteria ◽  
Low Profile ◽  
Flexible Flatfoot ◽  
Pain Patients

Background The Evans osteotomy is a widely used procedure for the correction of adult and pediatric flexible flatfoot deformity. Locking plates are commonly used to stabilize the osteotomy and the allograft. However, there have been incidences of soft-tissue irritation caused by the hardware, requiring subsequent hardware removal. Therefore, we sought to review whether age, sex, or laterality of the procedure had any correlation with the rate of hardware removal. Methods A retrospective review was performed of 47 consecutive patients who underwent an Evans calcaneal osteotomy between October 1, 2013, and October 1, 2016. Data were collected and analyzed based on age, sex, laterality, and the need for hardware removal. Results All of the 47 patients met the inclusion criteria. Seventy procedures were performed, and hardware removal was required in 16 patients and 21 feet (30%). The only statistically significant finding was that 11 females and only five males required either unilateral or bilateral hardware removal (P = .039). All 16 patients reported complete pain relief after hardware removal. Conclusions Females are twice as likely as males to develop symptoms after locking plate application over an Evans osteotomy and may require hardware removal. Despite the low-profile nature of the locking plate to fixate the Evans osteotomy, the hardware can be a source of significant pain. Patients, especially females, should be cautioned about potential hardware-related pain and a possible follow-up procedure to remove the hardware.

Ankle spanning external fixator with limited internal fixation for distal tibial extra-articular fractures

2017 ◽  
Vol 5 (10) ◽  
pp. 4355
Author(s):  
Siddharth Goel ◽  
Abhay Elhence
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
External Fixation ◽  
External Fixator ◽  
Tibial Fractures ◽  
Fixation Method ◽  
Ankle Pain ◽  
Distal Tibial Fractures ◽  
Tract Infections

Background: Fractures of the distal tibia are among the most difficult fractures to treat. The short distal segment presents difficulty in choosing the appropriate fixation method. The greatest challenge lies in the relatively tight soft tissue around the ankle. As a result, it has been a recent interest in treating these fractures with external fixation and limited internal fixation. The external stable fixation methods used are tubular or ring fixators, with or without immobilising the ankle. This minimally invasive nature of the surgery can avoid catastrophic wound complications like dehiscence, implant exposure and infection.Methods: 18 patients with extra-articular distal tibial fractures (AO Type 43A) were treated with the technique of ankle spanning external fixation. Lag screws or K-wires were supplemented for limited internal fixation when required. Fibula was stabilised in all cases. Intra- articular and Compound fractures were excluded. In addition to union at fracture site, ankle pain and motion was noted in each follow-up.Results: The mean follow-up was 25 months. Of the 18 patients included all but one fractures united with an average healing time of 16 to 18 weeks. Ankle pain and motion was graded according to Mazur modified by Teeny and Wiss clinical scoring system. 15 of them had excellent or good results, 2 had fair results. One patient had poor result. Five pin tract infections occurred. 17 patients had no evidence of osteoarthritis after completing follow up of at least 2 years.Conclusions: Distal tibial fractures are complex injuries, not only regarding the bony component, but also in terms of the management of the soft tissue problem. Ankle Spanning External Fixator with Limited Internal fixation is a relatively simple and cost-effective method for treating these fractures, achieving union and also maintaining ankle function.

Stifle arthrodesis using a locking plate system in six dogs

2015 ◽  
Vol 28 (04) ◽  
pp. 288-293 ◽  
Author(s):  
T. Nicetto ◽  
M. Petazzoni
Keyword(s):  
Body Weight ◽  
Medical Records ◽  
Tibial Fracture ◽  
Locking Plate ◽  
Sagittal Plane ◽  
Inclusion Criteria ◽  
Radiographic Outcomes ◽  
Locking Plate System ◽  
Plate System

SummaryObjectives: To describe the use of the Fixin locking plate system for stifle arthrodesis in dogs and to retrospectively report the clinical and radiographic outcomes in six cases.[uni2028]Materials and methods: Medical records of dogs that had arthrodesis with the Fixin locking plate system were reviewed. For each patient, data pertaining to signalment and implant used were recorded. Plate series and thickness, number of screws placed, number of cortices engaged, and screw diameters were also recorded. The outcome was determined from clinical and radiographic followups. Radiographic outcomes assessed included the measurement of the postoperative femoral-tibial angle in the sagittal plane.Results: Six dogs met the inclusion criteria for the study. Mean body weight was 13 kg (range: 3 - 34 kg). Radiographic follow-up (mean: 32 weeks, range: 3 - 52 weeks) was available for all dogs. In one case, an intra-operative complication occurred. In another case, a tibial fracture occurred 20 days after surgery. All arthrodeses healed and no implant complication was detected although all cases had mechanical lameness.Clinical significance: Stifle arthrodesis can be performed successfully using a Fixin locking plate system.

scholarly journals Comminuted olecranon fractures: locking compression plate fixation verses conventional plate fixation

2021 ◽  
Vol 7 (5) ◽  
pp. 1001
Author(s):  
Neetin P. Mahajan ◽  
Mrugank A. Narvekar ◽  
Lalkar L. Gadod ◽  
G. S. Prasanna Kumar
Keyword(s):  
Plate Fixation ◽  
Normal Function ◽  
Locking Compression Plate ◽  
Locking Plates ◽  
Plate Group ◽  
Significant Difference ◽  
Compression Plate ◽  
Conventional Plate ◽  
Olecranon Fractures

<p class="abstract"><strong>Background:</strong> A variable consensus exists on the optimal management strategies for olecranon fractures. Though the mechanical properties of the conventional plates and the locking plates used show no difference, pre-contoured locking plates provide a significant advantage over non-locking plates in unstable fractures. The aim of the study was to compare clinical and radiological outcomes in the management of the comminute olecranon fractures by anatomically pre-contoured locking compression plates and the conventional plates.</p><p class="abstract"><strong>Methods:</strong> The present study was a prospective study of 50 patients with comminuted olecranon fracture, with 25 patients each randomized into two groups, those that underwent fixation of the fracture using a pre-contoured locking compression plate (group LCP) and those fixed using a conventional plate (3.5 mm reconstruction plate) (group CP). Patients were followed up to 1 year with functional outcome assessed at each follow-up with Mayo elbow performance score.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean MEPS (LCP vs CP) at 1.5 (47 vs. 43.4) and 3 (67.4 vs 61.6) months follow up showed a statistically significant difference between the two groups, but the difference was not significant at 6 (86.4 vs 85.6) and 12 (88.4 vs 87) months. The time to union (4.3 months vs 5.0 months) was not significantly different between the groups. There were 11 complications in group LCP and 12 complications in group CP.</p><p class="abstract"><strong>Conclusions:</strong> In the present study, we suggest that the use of a pre-contoured locking compression plate provides better outcomes at earlier periods as compared to the conventional plate; thus, returning the patient to normal function at the earliest.</p>

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