J Korean Fract Soc.  2007 Jan;20(1):19-25. 10.12671/jkfs.2007.20.1.19.

Treatment of High-energy Distal Tibia Intraarticular Fractures with Two-staged Delayed Minimal Invasive Plate Osteosynthesis

• Sohn HM
• Lee JY
• Ha SH
• You JW
• Lee SH
• Lee KC

• KMID: 2294374
• DOI: http://doi.org/10.12671/jkfs.2007.20.1.19

Abstract

PURPOSE
To evaluate the short-term results of two-staged delayed minimal invasive plate osteosynthesis in high-energy intraarticular fractures of the distal tibia.
MATERIALS AND METHODS
Thirteen patients, who underwent two-staged delayed minimal invasive plate osteosynthesis for intraarticular fractures of the distal tibia between January 2002 and July 2004, were followed for more than one year. The mean interval time between first stage and second stage of the procedures was 28.6 days (range, 14~34 days). By Ruedi-Allgower classification, there were two cases in type I, three cases in type II, and eight cases in type III. There were six cases in type B and seven cases in type C patients according to AO/OTA classification. Radiographs were graded by the criteria of Burwell and Charnley and ankle functions were graded by the criteria of Mast and Teipner. Union time and postoperative complications were also analysed.
RESULTS
Average union time was 16.9 weeks (range, 14~20 weeks) in twelve of the thirteen fractures, but there was one fracture resulting in soft tissue complication and infected nonunion. At the latest follow-up, review of the radiographic results showed that ten cases of fractures (77%) achieved an anatomic reduction, two cases (15%) achieved fair reduction and one case (8%) achieved a poor reduction. And clinical functional assessment showed that nine cases (69%) were good results, three cases were (23%) fair results and one case (8%) was poor result.
CONCLUSION
Two-staged delayed minimal invasive plate osteosynthesis is an excellent option for the treatment of high-energy intraarticular fractures of the distal tibia.

Keyword

Tibia; Intraarticular fractures; Two-staged minimal invasive plate osteosynthesis

MeSH Terms

Ankle
Classification
Follow-Up Studies
Humans
Intra-Articular Fractures*
Postoperative Complications
Tibia*

Figure

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  Fig. 1 Limited incision by anterolateral arthrotomy.

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  Fig. 2 The 57-year-old male had a traffic accident, and sustained a Rüedi-Allgöwer type III fracture (A~C) and Gustilo-Anderson type IIIA open pilon fracture of right ankle (D). The patient underwent open reduction and internal fixation about fibular shaft fracture, closed reduction and external fixation about pilon fracture (E). The definitive procedure was performed days later and postoperative radiographs after two-staged delayed minimal invasive plate osteosynthesis show anatomic reduction, good alignment and articular congruity (F). Radiographs at the latest follow-up show complete bony union and no complication was developed (G).

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