FUNCTIONAL OUTCOME OF DISTAL TIBIA FRACTURES MANAGED WITH HYBRID RING FIXATOR

2021 ◽  
pp. 59-62
Author(s):  
Saksham Sharma ◽  
Rakesh Verma ◽  
Rahul Choudhary ◽  
Shiv Bhagwan Sharma
Keyword(s):  
Distal Tibia ◽  
High Energy ◽  
High Energy Trauma ◽  
Soft Tissue Envelope ◽  
Ring Fixator ◽  
Medical College ◽  
Tibia Fractures ◽  
Distal Tibia Fractures ◽  
The Common ◽  
Hybrid Ring

Introduction : distal tibia fractures are amongst the common open fractures encountered in day to day life owing to high energy trauma , the challenge to achieve union is added on due to absence of soft tissue envelope surrounding the bone apart from biological low blood supply Material and methods: this study was done in SRG Hospital and medical college , Jhalawar Rajasthan , comprising of 25 patients with open extra articular distal tibia fractures. Treated by reduction and external xation with ring hybrid xator. Results: The results were based on the objective and subjective parameters as described by Ovadia DN and Beals RK , we had 14 (56%) patients with excellent, 5 (20%) patient with good, 5 (20%) patients with fair and 1 (4%) patient with a poor outcome.

scholarly journals Result of Ring Fixator in High-energy Schatzker Type VI Fractures of Proximal Tibia

2021 ◽  
pp. 451-459
Author(s):  
Aftab Alam Khanzada ◽  
Muhammad Rafique Joyo ◽  
Muhammad Imran Javed ◽  
Nizam Ahmed ◽  
Niaz Hussain Keerio ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Tissue Damage ◽  
Proximal Tibia ◽  
High Energy ◽  
Soft Tissue Damage ◽  
Soft Tissue Envelope ◽  
Ring Fixator ◽  
Schatzker Type ◽  
Tibia Fractures ◽  
Proximal Tibia Fractures

Background: Significant articular depression, separation of both condyles, diaphyseal comminution and dissociation, and loss of soft-tissue envelope integrity are all associated with high-energy proximal tibia fractures (Schatzker VI). Over the past 50 years, there has been a lot of research on plating problems in these complicated fractures. For the care of these complex injuries, Ilizarov devised a new method (ring fixator). Aim of the Study: To examine the outcomes of patients who received a ring fixator for the treatment of high-energy proximal tibia fractures (Schatzker VI). Materials and Methods: Fourteen patients (mean age 36) were treated with the Ilizarov fixator and transfixion wires for high-energy fractures of the proximal tibia (Schatzker VI). Nine of the patients had open fractures, and five of them had significant soft tissue damage. They were all tracked for an average of 19.4 months. The result was analyzed using the criteria set by Honkonen & Jarvinen (1992). Results: Thirteen fractures healed in an average of 14.6 weeks, with one taking six months. Twelve patients recovered complete extension, while eight others regained more than 110 degrees of flexion. All of the patients knees were stable, except one who had a minor varus deformity. Nine patients walked normally, while four had a little limp. Except for one, all of the knees exhibited an articular step-off of less than 4 mm and normal axial alignment. Six knees were found to be outstanding, five to be decent, and three to be fair. There were no instances of postoperative skin infection or septic arthritis, however, three patients did have a pin tract infection that was effectively managed. Conclusion: The technique is suitable for the treatment of complex proximal tibia fractures when there is substantial comminution at the fracture site as well as soft tissue damage (Schatzker VI).

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 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.

Percutaneous ORIF of Periarticular Distal Tibia Fractures, Perspective 2

2015 ◽  
pp. 1-7
Author(s):  
Francesco Oliva ◽  
Rodrigo Buharaja ◽  
Alessio Giai Via ◽  
Nicola Maffulli
Keyword(s):  
Distal Tibia ◽  
Tibia Fractures ◽  
Distal Tibia Fractures

scholarly journals Distal Tibia Metaphyseal Fractures: Which is Better, Intra-medullary Nailing or Minimally Invasive Plate Osteosynthesis?

2018 ◽  
Vol 24 (1) ◽  
pp. 66-71
Author(s):  
Kawalkar Abhijit Chandrakant ◽  
Badole Chandrashekher Martand
Keyword(s):  
Intramedullary Nailing ◽  
Weight Bearing ◽  
Distal Tibia ◽  
Tibial Fractures ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Early Weight Bearing ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Tibia Fractures ◽  
Distal Tibia Fractures

Introduction Tibia fractures are the most common long bone fractures encountered by the orthopedic surgeons and distal tibia fractures have the second highest incidence of all tibia fractures after the middle third of tibia the distal tibial fractures are unique and are considered as most challenging fractures to treat due to its proximity to the ankle joint and its superficial nature. The objective of this study is to compare two osteosynthesis systems developed for surgical treatment of distal tibia fractures: the intramedullary nailing and the MIPPO technique. Methods The study was conducted between Jan 2011 to Dec 2012. 63 patients with extra-articular distal tibia fracture treated with intramedullary nailing and MIPPO technique were reviewed retrospectively and clinical outcome was evaluated according to American Orthopaedic Foot and Ankle Score. Results 31 patients were treated with intramedullary nail & 32 with MIPPO technique. Fibular fixation was done in cases where fibular fracture was at or below the level of tibial fractures. We found no difference in terms of time for fracture union, mal-union, non-union, duration of surgery and amount of blood loss. But there was significant difference in terms of infection and duration of hospital stay. Also weight bearing was possible much earlier in intramedullary group as compared to the MIPPO group. Conclusion Thus we conclude that intramedullary nailing is better choice of implant in patients with extra- articular distal tibia fractures & helps in early weight bearing and ambulation of patient with fewer complications.

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>

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