Yonsei Med J.  2013 May;54(3):720-725. 10.3349/ymj.2013.54.3.720.

Locking Plate in Proximal Tibial Fracture: A Correlation between the Coronal Alignment of Tibia and Joint Screw Angle

• Oh JK
• Hwang JH
• Varte L
• Ko JH
• Oh CW
• Jung DY
• An H
• Cho JW

• KMID: 1727889
• DOI: http://doi.org/10.3349/ymj.2013.54.3.720

Abstract

PURPOSE
The purpose of this study is to evaluate the relationship between the angle formed between the proximal most screw through the locking compression plate-proximal lateral tibia (LCP PLT) and the joint line, and to evaluate if this angle can be used intraoperatively as an assessment tool to determine normal alignment of the tibia in the coronal plane.
MATERIALS AND METHODS
There are two parts to this study: in the first part, LCP PLT was applied to 30 cadaveric adult tibia. The angle between the joint line and the proximal most screw was measured and termed as the 'joint screw angle' (JSA). In the second part, 56 proximal tibial fractures treated with LCP PLT were retrospectively studied. Two angles were measured on the radiographs, the medial proximal tibial angle (MPTA) and the JSA. Their relationship was analyzed statistically.
RESULTS
The average JSA was 1.16 degrees in the anatomical study. Statistical analysis of the clinical study showed that the normal MPTA had a direct correlation with an acceptable JSA.
CONCLUSION
We therefore conclude that the JSA can be used intraoperatively to assess the achievement of a normal coronal axis.

Keyword

Proximal tibial fracture; locking plate; tibial coronal alignment

MeSH Terms

Adult
Aged
Aged, 80 and over
*Bone Screws
Female
Humans
Male
Middle Aged
Orthopedic Procedures/*methods
Retrospective Studies
Tibial Fractures/radiography/*surgery

Figure

• 

  Fig. 1 (A) JSA=0: proximal most screw (PMS) is parallel to the joint line. (B) JSA (-): PMS tilted in varus with tip pointing towards joint line. (C) JSA (+): PMS tilted in valgus with tip pointing away from joint line. JSA, joint screw angle.

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