Top

International Orthopaedics

Published in:

01-08-2012 | Original Paper

Tibial fracture treated by minimally invasive plating using a novel low-cost, high-technique system

Authors: Bing Yin, Wei Chen, Qi Zhang, Juan Wang, Yanling Su, Guohui Xu, Yingze Zhang

Published in: International Orthopaedics | Issue 8/2012

Abstract

Purpose

The less invasive stabilization system (LISS) can effectively treat tibial fractures. However, the LISS is technically demanding, has a long learning curve, and presents a heavy economic burden to patients. The U-grooved locking compression plate (U-LCP), characterized by a U-groove at each end, is designed to treat tibial fractures. This paper reports the outcomes of tibial fractures treated using the U-LCP compared with the LISS.

Methods

Seventy-eight patients with unilateral tibial fractures treated with either the U-LCP (group I) or LISS (group II) were enrolled. In group I, a U-LCP was inserted subcutaneously with two Kirschner wires embedded into the U-grooves to temporarily secure the plate. A second identical plate was placed over the first to guide screw insertion. In group II, the LISS was used to fix the tibial fractures. Patient age, sex, fracture type, severity of soft tissue injury, operative time, fluoroscopic time, complications, and functional recovery of affected limbs were recorded.

Results

The two groups were comparable in age, sex, fracture type, and severity of soft tissue injury (p > 0.05). The average operation and fluoroscopic times in group I were significantly less than those in group II (p < 0.05). At follow-up, all fractures healed. There were no significant differences between both groups in time to bony union, wound complication rate, or functional recovery of injured limbs (p > 0.05).

Conclusions

The U-LCP can yield good outcomes in the treatment of proximal tibial fractures, with less radiation exposure, a shorter operation time, and a sustainable price compared with the LISS.

Krettek C, Schandelmaier P, Nliclau T et al (1997) Minimally invasive percutaneous plate osteosynthesis (MIPPO) using the DCS in proximal and distal femoral fractures. Injury 28:20–30CrossRef

Williams T, Schenk W (2008) Bridging-minimally invasive locking plate osteosynthesis (Bridging-MILPO): technique description with prospective series of 20 tibial fractures. Injury 39(10):1198–1203PubMedCrossRef

Giri S, Dirga Raj R, Gurung B et al (2009) Minimal invasive percutaneous plate osteosynthesis of fracture of tibia. PMJN 2(7):17–23

Cole P, Zlowodzki M, Kregor P (2004) Treatment of proximal tibia fractures using the less invasive stabilization system: surgical experience and early clinical results in 77 fractures. J Orthop Trauma 18(8):528–535PubMedCrossRef

Ricci WM, Rudzki JR, Borrelli J Jr (2004) Treatment of complex proximal tibia fractures with the less invasive skeletal stabilization system. J Orthop Trauma 18(8):521–527PubMedCrossRef

Boldin C, Fankhauser F, Hofer HP et al (2006) Three-year results of proximal tibia fractures treated with the LISS. Clin Orthop Relat Res 445:222–229PubMed

Schutz M, Muller M, Krettak C et al (2001) Minimally invasive fracture stabilization of distal femoral fractures with the LISS: a prospective multi-center study; results of a clinical study with special emphasis on difficult cases. Injury 32(suppl 3):48–54CrossRef

Hak DJ, Stewart RL, Lee M (2004) Preliminary stabilization of the less invasive stabilization system. J Orthop Trauma 18(8):559–561PubMedCrossRef

Grist BD, Rocca GJD, Murtha YM (2008) Treatment of acute distal femur fractures. Orthopedics 31(7):681–690CrossRef

10.

Chen W, Zhang Q, Su Y et al (2012) Minimally invasive plate osteosynthesis of tibial fracture using self-navigated plate. Eur J Orthop Surg Traumatol 22(2):163–166. doi:10.1007/s00590-011-0783-0

11.

Gustilo R, Anderson J (1976) Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am 58(4):453–458PubMed

12.

Oestern H, Tscherne H (1984) Pathophysiology and classification of soft tissue injuries associated with fractures. Fractures with soft tissue injuries. Springer-Verlag, Berlin, pp 1–9

13.

Hou Z, Zhang Q, Zhang Y et al (2009) A occult and regular combination injury: the posterior malleolar fracture associated with spiral tibial shaft fracture. J Trauma 66(5):1385–1390PubMedCrossRef

14.

Ricci WM, Rudski JR, Borrelli J Jr (2004) Treatment of complex proximal tibia fractures with the less invasive skeletal stabilization system. J Orthop Trauma 18:521–527PubMedCrossRef

15.

Wu CC (2006) Salvage of proximal tibial malunion or nonunion with the use of angled blade plate. Arch Orthop Trauma Surg 126:82–87PubMedCrossRef

16.

Johner R, Wruhs O (1983) Classification of tibial shaft fractures and correlation with results after rigid internal fixation. Clin Orthop Relat Res 178:7–25PubMed

17.

Toms AD, McMurtie A, Maffulli N (2004) Percutaneous plating of the distal tibia. J Foot Ankle Surg 43(3):199–203PubMedCrossRef

18.

Babst R, Hehli M, Regazzoni P (2001) LISS tractor. Combination of the "less invasive stabilization system" (LISS) with the AO distractor for distal femur and proximal tibial fractures. Unfallchirurg 104(6):530–535PubMedCrossRef

19.

Schütz M, Müller M, Kääb M et al (2000) Minimal invasive Frakturstabilisierung von distalen Femurfrakturen mit dem LISS-System-Ergebnisse einer prospektiven Multizenter-Studie. Acta Chir Austriaca 32(suppl 2):83–84

20.

Jiang R, Luo CF, Wang MC, Yang TY et al (2008) A comparative study of less invasive stabilization system (LISS) fixation and two-incision double plating for the treatment of bicondylar tibial plateau fractures. Knee 15(2):139–143PubMedCrossRef

21.

Gautier E, Sommer C (2003) Guidelines for the clinical application of the LCP. Injury 34(suppl 2):B63–B76PubMedCrossRef

22.

Boraiah S, Kemp T, Erwteman A et al (2010) Outcome following open reduction and internal fixation of open pilon fractures. J Bone Joint Surg Am 92(2):346–352PubMedCrossRef

23.

He W, Jakob R (1986) Zur Problematik der Plattenosteosynthese bei den bikondylären Tibiakopffrakturen. Der Unfallchirurg 89(7):304–311

24.

Vallier HA, Hennessey TA, Sontich JK et al (2006) Failure of LCP condylar plate fixation in the distal part of the femur. A report of six cases. J Bone Joint Surg Am 88(4):846–853PubMedCrossRef

Title: Tibial fracture treated by minimally invasive plating using a novel low-cost, high-technique system
Authors: Bing Yin
Wei Chen
Qi Zhang
Juan Wang
Yanling Su
Guohui Xu
Yingze Zhang
Publication date: 01-08-2012
Publisher: Springer-Verlag
Published in: International Orthopaedics / Issue 8/2012
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-012-1547-0

At a glance: The STEP trials

Springer Medicine

Tibial fracture treated by minimally invasive plating using a novel low-cost, high-technique system

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 8/2012

Effect of nerve growth factor and its transforming tyrosine kinase protein and low-affinity nerve growth factor receptors on apoptosis of notochordal cells

The clinical and radiographical results of reverse total shoulder arthroplasty with eccentric glenosphere

Smartphones in orthopaedics

Total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fractures in the healthy elderly: a meta-analysis and systematic review of randomized trials

Secondary cement injection technique reduces pulmonary embolism in total hip arthroplasty

Measuring the Cobb angle with the iPhone in kyphoses: a reliability study