scholarly journals Minimally invasive internal fixation of distal tibia fractures with a nonconventional implant:

2020 ◽  
Vol 14 (2) ◽  
pp. 201-204
Author(s):  
Luiz Augusto Bittencourt Campinhos ◽  
Nelson Elias ◽  
José Eduardo Grandi Ribeiro Filho ◽  
Elton Luiz Batista Cavalcante
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Distal Tibia ◽  
High Energy ◽  
Joint Involvement ◽  
Invasive Technique ◽  
Level Of Evidence ◽  
Tibia Fractures ◽  
Distal Tibia Fractures ◽  
Invasive Techniques

Fractures of the distal end of the tibia without joint involvement are usually the result of high-energy trauma. Local anatomic conditions lead to high rates of infection, delayed consolidation, and exposure of fixation hardware. In this setting, minimally invasive techniques are indicated to mitigate the complications of surgical treatment. The aim of this study is to present an alternative for the surgical treatment of distal tibia fractures using a minimally invasive technique and a nonconventional implant. Level of Evidence V; Therapeutic Studies; Expert Opinion.

scholarly journals Minimally Invasive Percutaneous Plate Osteosynthesis: A Blessing for Notorious Distal Tibia Fractures

2020 ◽  
Author(s):  
Manjunath Daragad ◽  
Shrihari L Kulkarni ◽  
Sunil Mannual ◽  
Sachin Kumar
Keyword(s):  
Minimally Invasive ◽  
Soft Tissues ◽  
Plate Osteosynthesis ◽  
Distal Tibia ◽  
High Energy ◽  
P Value ◽  
Surgical Trauma ◽  
Tibia Fractures ◽  
Distal Tibia Fractures ◽  
One Year

Introduction: Fractures of distal tibia are difficult to treat as they are high energy fractures, associated with extremely damaged soft tissues, poor vascularity, high incidence of compound injuries, skin complications following surgery and comminution of the metaphysis and articular surface makes anatomical reduction difficult. A mechanically stable osteosynthesis can be obtained with minimum dissection and surgical trauma by Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO). In this technique fracture is reduced indirectly, and is fixed with Locking Compression Plate (LCP). Aim: To assess functional and radiological outcomes of distal tibial fractures managed by MIPPO using LCP. Materials and Methods: In this cross-sectional study, 25 patients with distal tibia fractures were operated by LCP using MIPPO technique. Patients were followed-up at regular intervals for about one year. They were assessed clinically, functionally and with radiologically for fracture union. Functional assessment was done using American Orthopaedic Foot and Ankle Society Score (AOFAS) scoring system. Radiological outcome was evaluated using the Radiological Union Scale in Tibia Fracture (RUST) to assess union. Data was analysed using paired t-test. The chosen level of significance was p-value <0.05. Statistical Package for the Social Sciences (SPSS) version 21 was used for analysis. Results: Males were more commonly affected with Road Traffic Accident (RTA) being the most common mode of injury. All fractures healed with good functional outcome. Mean union time was 20 weeks. Mean AOFAS score at the end of one year was 88.83 (SD 5.65) and mean RUST score was 11.58 (SD 0.72) at the end of one-year follow-up, indicating good outcome. There was one case of superficial infection which was managed with antibiotics, one patient had implant failure. Conclusion: LCP using MIPPO offers biological advantage by preserving periosteal blood supply, which is particularly critical with distal tibia or pilon injury. Thus, fractures heal rapidly with very few complications.

Minimally Invasive Plating of High-Energy Metaphyseal Distal Tibia Fractures

2007 ◽  
Vol 21 (6) ◽  
pp. 355-361 ◽  
Author(s):  
Cory Collinge ◽  
Mark Kuper ◽  
Kirk Larson ◽  
Robert Protzman
Keyword(s):  
Minimally Invasive ◽  
Distal Tibia ◽  
High Energy ◽  
Tibia Fractures ◽  
Distal Tibia Fractures ◽  
Minimally Invasive Plating

scholarly journals Functional outcome of minimally invasive plate osteosynthesis with the use of locking plate in fracture distal end of tibia

2020 ◽  
Vol 6 (6) ◽  
pp. 1239
Author(s):  
Prashant Kamble ◽  
Nandan Marathe ◽  
Sudhir Sharan ◽  
Ayush Sharma ◽  
Ashwin Sathe ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Open Reduction ◽  
Plate Osteosynthesis ◽  
Distal Tibia ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Locking Plates ◽  
X Rays ◽  
Functional Scores ◽  
Tibia Fractures ◽  
Distal Tibia Fractures

<p class="Body"><strong>Background : </strong>Distal tibia fractures or pilon fractures are usually the result of combined compressive and shearing forces, which may lead to instability of the metaphysis. Poor vascularity, lack of muscle cover and frequent intra-articular extension often make these fractures very challenging to manage. There are plenty of options available to treat a distal tibia fracture which includes intramedullary nailing, external fixation, open reduction and internal fixation and minimally invasive plate osteosynthesis (MIPO). The aim of this study was to evaluate the results of MIPO with respect to the healing of fracture site, the incidences of complications and to conclude whether MIPO circumvents the problems of formal open reduction and fixation with other implants.</p><p class="Body"><strong>Methods: </strong>A series of forty patients with fracture of the distal tibia on preoperative X-rays were treated with minimally invasive plate osteosynthesis using pre-contoured locking plates from June 2014 to October 2018 and followed up at regular intervals with X-rays and monitoring for complications.</p><p class="Body"><strong>Result: </strong>The functional scores were evaluated using Teeny and Wiss clinical rating system for ankle joints. Thirty-two patients had an ‘Excellent’ or ‘Good’ outcome. One patient was diagnosed with a soft tissue complication and delayed union and 3 patients were diagnosed with malunion without significant functional disability at follow up. <strong></strong></p><p class="Body"><strong>Conclusion: </strong>Minimally invasive plate osteosynthesis with pre-contoured locking plates is associated with high union rate and good functional outcomes. It is an effective treatment modality for distal tibia fractures.</p>

Mid-Term Results of Minimally Invasive Plate Osteosynthesis and Circular External Fixation in the Treatment of Complex Distal Tibia Fractures

2017 ◽  
Vol 107 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Yunus Imren ◽  
Engin Eren Desteli ◽  
Mehmet Erdil ◽  
Hasan Hüseyin Ceylan ◽  
Ibrahim Tuncay ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
External Fixation ◽  
Bone Grafting ◽  
Plate Osteosynthesis ◽  
Distal Tibia ◽  
Plate Group ◽  
Tibia Fractures ◽  
Distal Tibia Fractures ◽  
Tract Infections

Background: The treatment of pilon tibia fractures is challenging. Anatomical reduction of the joint surface is essential. Excessive soft-tissue dissection may interfere with the blood supply and can result in nonunion. We sought to compare the outcomes of distal tibia fractures treated with medial locking plates versus circular external fixators. Methods: We retrospectively evaluated 41 consecutive patients with closed pilon tibia fractures treated with either minimally invasive locking plate osteosynthesis (n = 21) or external fixation (EF) (n = 20). According to the Ruedi and Allgower classification, 23 fractures were type B and 18 were type C. Soft-tissue injury was evaluated according to the Oestern and Tscherne classification. Time to fracture union, complications, and functional outcomes were assessed annually for 3 years with the American Orthopaedic Foot and Ankle Society (AOFAS) ankle score. Results: Mean ± SD values in the plate group were as follows: age, 42.4 ± 14 years; union time, 19.4 ± 2.89 weeks (range, 12–26 weeks); and AOFAS ankle scores, 86.4 ± 2.06, 79.5 ± 1.03, and 77.9 ± 0.80 at 1, 2, and 3 years, respectively. Four patients in the plate group needed secondary bone grafting during follow-up. In the EF group (mean ± SD age, 40.7 ± 12.3 years), all of the patients achieved union without secondary bone grafting at a mean ± SD of 22.1 ± 1.7 weeks (range, 18–24 weeks). In the EF group, mean ± SD AOFAS ankle scores were 86.6 ± 1.69, 82.1 ± 0.77, and 79.7 ± 1.06 at 1, 2, and 3 years, respectively. There were no major complications. However, there were soft-tissue infections over the medial malleolus in five patients in the plate group and grade 1-2 pin-tract infections in 13 patients and grade 3 pin-tract infections in one patient in the EF group. Post-traumatic arthritis was detected in eight plate group patients and seven EF group patients. Conclusions: Minimally invasive plating and circular EF methods have favorable union rates with fewer complications.

scholarly journals Two Stage Minimally Invasive Method with Locking Plate Application on Distal Tibia Fractures - Our Experience

2017 ◽  
Vol 5 (5) ◽  
pp. 630-634
Author(s):  
Ilir Hasani ◽  
Igor Kaftandziev ◽  
Slavco Stojmenski ◽  
Simon Trpeski ◽  
Hristijan Kostov ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Functional Outcomes ◽  
Locking Plate ◽  
Plate Fixation ◽  
Distal Tibia ◽  
Locking Plate Fixation ◽  
Two Stage ◽  
Tibia Fractures ◽  
Invasive Method ◽  
Distal Tibia Fractures

INTRODUCTION: In the past distal tibia fractures, including intraarticular fractures, frequently led to poor functional outcomes. The Ruedi-Allgower four steps open method, and later the Patterson and Sirkin recommendations for delayed operative treatment has made a drastic advancement in the treatment of these fractures. The two-stage minimally-invasive protocol using locking plate fixation proved a historical turning point, improving functional results to the highest levels compared to all other methods.AIM: To present the superior results of the two-stage minimally-invasive method using locking plate fixation, making this a historic step forward in treating distal tibia fractures.MATERIAL AND METHODS: A prospective longitudinal study, collecting data from Traumatology-Clinic in the 2014-2016 periods, available for nine-month follow-up. Twenty-three patients were finally included in the study.RESULTS: In analysing the data collected, we focused our attention on the final functional outcomes as indicated by dorsiflexion nine months after injury and also according to the AOFAS Ankle-Hindfoot Scale. Results were excellent with no or minimal consequences. Where complications were present, these were benign and did not require further surgery.CONCLUSION: We believe this modern method for the treatment of distal tibia fractures should be applied routinely and considered as the gold standard in this domain.

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