Skip to main content
Top
Published in: International Orthopaedics 11/2015

Open Access 01-11-2015 | Original Paper

Comparison of different locking plate fixation methods in distal tibia fractures

Authors: Krzysztof Piątkowski, Piotr Piekarczyk, Krzysztof Kwiatkowski, Mateusz Przybycień, Bartłomiej Chwedczuk

Published in: International Orthopaedics | Issue 11/2015

Login to get access

Abstract

Purpose

The aim of our study was to assess the outcome of locking plate fixation of distal tibia fractures and evaluate which surgical approach and method of plate fixation is related to better functional result and lower complication rate.

Methods

A retrospective analysis of treatment of 45 patients was made. Patients were divided into two subgroups regarding surgical approach (medial vs anterior) and fixation method (bridge plating vs rigid fixation). Time from injury to full bone union was noted, and clinical outcome was assessed by AOFAS score.

Results

Nonunion was the most prevalent complication and was observed in 26.6 % of patients. Infection rate was 11.1 %. Higher rate of bone union complications was noted in the anterior approach group with anterolateral anatomical plate. Infection and re-operation rates were similar in all subgroups. There were no correlations between fracture extension, length of plate and screw placement with bone healing time and AOFAS score.

Conclusions

Outcome of plate fixation of distal tibia fracture did not depend on the fixation method or surgical approach but, when possible, the medial plating via MIPO technique is a favourable method of treatment.
Literature
1.
go back to reference Michelson J, Moskovitz P, Labropoulos P (2004) The nomenclature for intra-articular vertical impact fractures of the tibial plafond: pilon versus pylon. Foot Ankle Int 25:149–150PubMed Michelson J, Moskovitz P, Labropoulos P (2004) The nomenclature for intra-articular vertical impact fractures of the tibial plafond: pilon versus pylon. Foot Ankle Int 25:149–150PubMed
3.
go back to reference McFerran MA, Smith SW, Boulas HJ, Schwartz HS (1992) Complication encountered in the treatment of pilon fractures. J Orthop Trauma 6(2):195–200CrossRefPubMed McFerran MA, Smith SW, Boulas HJ, Schwartz HS (1992) Complication encountered in the treatment of pilon fractures. J Orthop Trauma 6(2):195–200CrossRefPubMed
4.
go back to reference Cesari B, Lortat-Jacob A, Dinh A, Katabi M, Decrette E, Benoit J (1996) Fractures of the anterior rim of the distal part of the tibia. Apropos of a series of 38 cases. Rev Chir Orthop Reparatrice Appar Mot 82(5):417–427PubMed Cesari B, Lortat-Jacob A, Dinh A, Katabi M, Decrette E, Benoit J (1996) Fractures of the anterior rim of the distal part of the tibia. Apropos of a series of 38 cases. Rev Chir Orthop Reparatrice Appar Mot 82(5):417–427PubMed
8.
go back to reference Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 15(7):349–353CrossRefPubMed Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 15(7):349–353CrossRefPubMed
9.
go back to reference Lee YS, Chen SH, Lin JC, Chen YO, Huang CR, Cheng CY (2009) Surgical treatment of distal tibia fractures: a comparison of medial and lateral plating. Orthopedics 32(3):163CrossRefPubMed Lee YS, Chen SH, Lin JC, Chen YO, Huang CR, Cheng CY (2009) Surgical treatment of distal tibia fractures: a comparison of medial and lateral plating. Orthopedics 32(3):163CrossRefPubMed
10.
go back to reference Teeny SM, Wiss DA (1993) Open reduction and internal fixation of tibial plafond fractures. Variables contributing to poor results and complications. Clin Orthop Relat Res 292:108–117PubMed Teeny SM, Wiss DA (1993) Open reduction and internal fixation of tibial plafond fractures. Variables contributing to poor results and complications. Clin Orthop Relat Res 292:108–117PubMed
14.
go back to reference Kline AJ, Gruen GS, Pape HC, Tarkin IS, Irrgang JJ, Wukich DK (2009) Early complications following the operative treatment of pilon fractures with and without diabetes. Foot Ankle Int 30(11):1042–1047. doi:10.3113/FAI.2009.1042 CrossRefPubMed Kline AJ, Gruen GS, Pape HC, Tarkin IS, Irrgang JJ, Wukich DK (2009) Early complications following the operative treatment of pilon fractures with and without diabetes. Foot Ankle Int 30(11):1042–1047. doi:10.​3113/​FAI.​2009.​1042 CrossRefPubMed
15.
17.
go back to reference Encinas-Ullán CA, Fernandez-Fernandez R, Rubio-Suárez JC, Gil-Garay E (2013) Medial versus lateral plating in distal tibial fractures: a prospective study of 40 fractures. Rev Esp Cir Ortop Traumatol 57(2):117–122. doi:10.1016/j.recot.2012.11.004 PubMed Encinas-Ullán CA, Fernandez-Fernandez R, Rubio-Suárez JC, Gil-Garay E (2013) Medial versus lateral plating in distal tibial fractures: a prospective study of 40 fractures. Rev Esp Cir Ortop Traumatol 57(2):117–122. doi:10.​1016/​j.​recot.​2012.​11.​004 PubMed
18.
go back to reference Hasenboehler E, Rikli D, Babst R (2007) Locking compression plate with minimally invasive plate osteosynthesis in diaphyseal and distal tibial fracture: a retrospective study of 32 patients. Injury 38(3):365–370CrossRefPubMed Hasenboehler E, Rikli D, Babst R (2007) Locking compression plate with minimally invasive plate osteosynthesis in diaphyseal and distal tibial fracture: a retrospective study of 32 patients. Injury 38(3):365–370CrossRefPubMed
19.
go back to reference Horn C, Döbele S, Vester H, Schäffler A, Lucke M, Stöckle U (2011) Combination of interfragmentary screws and locking plates in distal meta-diaphyseal fractures of the tibia: a retrospective, single-centre pilot study. Injury 42(10):1031–1037. doi:10.1016/j.injury.2011.05.010 CrossRefPubMed Horn C, Döbele S, Vester H, Schäffler A, Lucke M, Stöckle U (2011) Combination of interfragmentary screws and locking plates in distal meta-diaphyseal fractures of the tibia: a retrospective, single-centre pilot study. Injury 42(10):1031–1037. doi:10.​1016/​j.​injury.​2011.​05.​010 CrossRefPubMed
Metadata
Title
Comparison of different locking plate fixation methods in distal tibia fractures
Authors
Krzysztof Piątkowski
Piotr Piekarczyk
Krzysztof Kwiatkowski
Mateusz Przybycień
Bartłomiej Chwedczuk
Publication date
01-11-2015
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 11/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-2906-4

Other articles of this Issue 11/2015

International Orthopaedics 11/2015 Go to the issue