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International Orthopaedics
Published in: International Orthopaedics 7/2014

01-07-2014 | Original Paper

Distal tibia fractures and medial plating: factors influencing re-operation

Authors: Vasanth Sathiyakumar, Rachel V. Thakore, Rivka C. Ihejirika, William T. Obremskey, Manish K. Sethi

Published in: International Orthopaedics | Issue 7/2014

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Abstract

Purpose

We compared types of complications leading to re-operations in open and closed distal tibia fractures treated by locking or nonlocking medial plates.

Methods

Ninety-three patients from 2002 to 2012 who underwent open reduction and internal fixation (ORIF) and medial plating for distal extra-articular or partial articular tibia fractures were identified. Charts were retrospectively reviewed to determine the incidence of re-operation based on the type of complication that developed. Fisher’s exact and chi-square tests were performed to analyze the incidence of complications based on injury and type of plate used.

Results

Thirty-three (35.5 %) patients required re-operations: 28.6 % (n = 16) with closed injuries had complications leading to re-operations compared with 45.9 % (n = 17) of patients with open injuries (p = 0.12). Patients with closed injuries were more likely to require re-operation due to hardware pain/prominence (p = 0.03), whereas patients with open injuries were more likely to require re-operation due to nonunion (p = 0.04). There were no significant differences in infection (p = 0.66) or malunion (p = 0.99) between groups. Locking plates showed higher costs but were not associated with decreased risk of re-operation.

Conclusions

There was a high re-operation rate associated with distal tibia medial plating, with significant differences in the reason for re-operation between open versus closed groups. Complication rates were not influenced by the use of locking plates. Results of this study suggest that methods be considered to reduce re-operation based on type of fracture, such as early bone grafting or the use of alternate implants for open fractures.
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Metadata
Title
Distal tibia fractures and medial plating: factors influencing re-operation
Authors
Vasanth Sathiyakumar
Rachel V. Thakore
Rivka C. Ihejirika
William T. Obremskey
Manish K. Sethi
Publication date
01-07-2014
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 7/2014
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-014-2345-7

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