J Korean Fract Soc.  2012 Jan;25(1):20-25. 10.12671/jkfs.2012.25.1.20.

Comparative Analysis of Minimally Invasive Plate Osteosynthesis Using Periarticular Plate and Intramedullary Nailing in Distal Tibial Metaphyseal Fractures

• Lee GC
• Lee JY
• Ha SH
• Sohn HM
• Park YK

• KMID: 1434106
• DOI: http://doi.org/10.12671/jkfs.2012.25.1.20

Abstract

PURPOSE
To compare results between minimally invasive plate osteosynthesis using a periarticular plate and intramedullary nailing in distal tibial metaphyseal fractures in two treatment groups.
MATERIALS AND METHODS
Sixty-one cases of distal tibial metaphyseal fractures from December 2008 to December 2009 were evaluated. The minimal follow-up period was 12 months. Thirty patients treated by minimally invasive plate osteosynthesis using a periarticular plate were Group A; 31 patients treated by intramedullary nailing were Group B. We compared and analyzed the results of each group by radiological and clinical assessments.
RESULTS
The mean bony union time was 16.4 weeks in Group A and 17.2 weeks in Group B. The mean operation time was 45 minutes in Group A and 48 minutes in Group B. The mean radiation exposure times were 4.2 minutes and 4.8 minutes, respectively. VAS scores were 0.7 points and 0.5 points in each respective group. In Group A, the VAS score was 1.7 points when we applied pressure on the skin around the plate. The mean Olerud and Molander Ankle Score was 87.4 points and 86.3 points, respectively. A superficial wound infection occurred in 1 case in each group, and angular deformities more than 5 degrees occurred in 2 Group B cases.
CONCLUSION
No significant differences in results were observed between the two groups. However, a higher incidence of angular deformity was seen in the intramedullary nailing group. Therefore, we must be careful during surgery.

Keyword

Distal tibial metaphyseal fractures; Minimally invasive plate osteosynthesis (MIPO); Intramedullary nailing

MeSH Terms

Animals
Ankle
Congenital Abnormalities
Follow-Up Studies
Fracture Fixation, Intramedullary
Humans
Incidence
Skin
Wound Infection

Figure

• 

  Fig. 1 The fluoroscopic X-rays reveals joy stick method that parallel K-wire fixation on distal tibia for more accurate reduction during insertion of ball-tip guide wire and reaming of the medullary canal (In this case, excute conservative treatment about fibular fracture).

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  Fig. 2 The fluoroscopic X-rays (A~D) reveal using the poller screw for accurate insertion nail. Postoperative X-ray, (E) anteroposterior, and (F) lateral view.

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