J Korean Fract Soc.  2010 Jul;23(3):296-302. 10.12671/jkfs.2010.23.3.296.

Comparative Study Using of Treatment with Minimally Invasive Plate Osteosynthesis Using Periarticular Plate and Interlocking Intramedullary Nailing in Distal Tibia Fractures

• Hong CH
• Park JS
• Lee SS
• Awe SI
• Kim WJ
• Jung KJ

• KMID: 1712345
• DOI: http://doi.org/10.12671/jkfs.2010.23.3.296

Abstract

PURPOSE
To compare the result of treatment between minimally invasive plate osteosynthesis (MIPO) using periarticular plate and intramedullary nailing in treatment of distal tibia fractures.
MATERIALS AND METHODS
28 cases of distal tibia fractures form Jan. 2006 to Mar. 2008 were divided into two group. Minimum follow-up was for 12 month. Group 1 consisted of 14 patients who were treated by MIPO technique and group 2 consisted of 14 patients who were treated by interlocking intramedullary nailing. The results were compared by assessing radiologic and clinical result.
RESULTS
The mean bony union time was 14 weeks (8~17) in group 1 and 15 weeks (11~20) in group 2. Operation time was 58 minutes (55~65) in group 1 and 82.7 minutes (70~100) in group 2. The average angulation in AP view was 1.5 degrees (0~2) in group 1 and 2 degrees (0~5) in group 2, in lateral view was 1.8 degrees (0~4) in group 1 and 2.3 degrees (0~12) in group 2. The average range of motion for dorsi flextion was 17.5 degrees (15~20) in group 1 and 18 degrees (16~20) in group 2, for plantar flextion was 45 degrees (42~50) in group 1 and 44 degrees (42~50) in group 2, which means that there were no severe limitation of motion in all patients, resulting in satisfactory ambulation. There was no post operative complications such as skin irritation problem caused by internal device and no implant failure and superficial wound infection.
CONCLUSION
There were no difference in bony union time, clinical result and anatomical reduction between Group 1 and Group 2 in distal tibia fractures, but operation time was shorter in MIPO than nailing.

Keyword

Distal tibia fracture; Minimally invasive plate osteosynthesis (MIPO); Interlocking intramedullary nailing

MeSH Terms

Follow-Up Studies
Fracture Fixation, Intramedullary
Humans
Nails
Range of Motion, Articular
Skin
Tibia
Walking
Wound Infection

Figure

• 

  Fig. 1 A 16 years-old female sustained a fracture of left distal tibia after slip down injury. (A) Preoperative radiograph shows left distal tibia fracture. (B) Postoperative radiograph after minimally invasive internal fixation with periarticular plate. (C) The 12 months postoperative radiograph show stable bony union.

• 

  Fig. 2 A 28 years-old male sustained a fracture of right distal tibia after slip down injury. (A) Preoperative radiograph shows right distal tibia fracture. (B) Postoperative radiograph after interlocking intramedullary nail fixation. (C) The 21 months postoperative radiograph after metal removal show stable bony union.

• 

  Fig. 3 (A) Periarticular Plate (Zimmer®, USA), (B) Reamed Tibial Nail (ACE®, USA).

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  Fig. 4 The 2 weeks postoperative photo after minimally invasive percutaneous internal fixation with periarticular plate. There was no post operative complication such as skin irritation problem.

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