Kosin Med J.  2014 Jun;29(1):23-29. 10.7180/kmj.2014.29.1.23.

Minimally Invasive Plate Osteosynthesis for Fractures of Distal Tibia

• Kim TH
• Chung SH

• KMID: 1882435
• DOI: http://doi.org/10.7180/kmj.2014.29.1.23

Abstract

OBJECTIVES
This study analyzed clinical and radiologic results, and complications of minimally invasive plate osteosynthesis(MIPO) for distal tibia fracture.
METHODS
16 patients (17 cases) who were performed MIPO for distal tibia fractures between January 2007 and June 2011, post-operative followed up at least for one year, were selected for this study. The average age was 55.0(26-76) years old and the average period of follow-up was 15.1(6-27) months. Most of the patients were encouraged to perform ankle dorsiflexion and straight leg raising exercise on splints, from the next day of the operation. As radiologic evaluation, we checked period until bone union, degree of angulation. And post-operative complications were also checked. For functional evaluation of the ankles, American Orthopaedic Foot and Ankle Society(AOFAS) score was used.
RESULTS
16 of the 17 cases were achieved primary bone union, and average period of bone union in all the cases was 17.4 (12-42) weeks. Mean varus/valgus angulation after the bone union was 0.8 degrees and mean anteroposterior(AP) angulation was 1.8 degrees. Mean AOFAS score was 85.2(71-95) points; 5 cases of excellent, 10 cases of good, 1 case of fair, showing that 93.8% of the patients represented at least good AOFAS scores. As complications, there were 2 cases of superficial infection, and each 1 case of nonunion and skin irritation. There were no cases of deep infection, metal breakage, nor limb length discrepancy.
CONCLUSIONS
MIPO for distal tibia fracture is considered to be an effective operative method, because of its high bone union rate and low complications by minimal disruption of soft tissue and improved bone fixation strength. Also, for earlier return to daily life, ankle joint exercise should be started as soon as possible after the operation.

Keyword

Distal tibia; Early range-of-motion exercise; Facture; Mimimally invasive plate osteosynthesis (MIPO)

MeSH Terms

Ankle
Ankle Joint
Extremities
Follow-Up Studies
Foot
Humans
Leg
Skin
Splints
Tibia*

Figure

• 

  Fig. 1. (A) A 73 yeared-old woman was sustained distal tibiofibular comminuted fracture by slip down. (B) The distal tibia fracture was stabilized with LCP metaphyseal plate using minimal invasive technique. (C) At 16 weeks postoperatively, radiographs shows bone union.

• 

  Fig. 2. (A) A 65-yeared old woman was sustained distal tibiofibular fracture by slip down. (B) The distal tibia fracture was treated with MIPO technique using LCP metaphyseal plate on medial side. (C) At 12 weeks postoperatively, radiograph shows bone union.

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