PURPOSE This study demonstrates the effectiveness of the blade plate as an implant for the operative management of proximal tibial fractures. MATERIALS AND METHODS Twelve proximal tibial fractures (AO classification, 10 type A and 2 type C) were treated by direct or indirect reduction and condylar blade plate fixation. The condylar blade plate was fixed on the anteromedial surface of the proximal tibia and cancellous bone graft was performed in 4 fractures with severe cortical comminution or bone defect in early cases. At the final follow-up assessment, the patients were evaluated as to subjective symptoms, objective findings, and radiographic findings. RESULTS All fractures were healed in an average of 13.2 weeks (range, 9.0 to 25.0 weeks). There were 3 major complications of a delayed union, a 6-degree varus malunion, and a reduced range of motion of the knee related with associated multiple fractures of the ipsilateral lower limb, but there were no soft tissue problems, loss of fixation, infection, nonunion, and traumatic arthritis. A few patients complained a prominence of the plate on the anteromedial side of the proximal tibia. CONCLUSION Blade plate fixation is a reliable method of stable fixation to obtain good results for proximal tibial fractures by early rehabilitation and good fracture healing, particularly in patients with osteoporosis and cortical comminution.
We have experienced a fatigue fracture occurred in the calcaneus of 49-year-old man and an insufficiency fracture occurred in the juxtatectal region of acetabulum in 70 -year-old woman.
Both cases healed successively after rest. We suggest these fractures must be considered in differential diagnosis.
We have experienced five cases of intraoperative fracture of the tibia assoicated with removal of ACE interlocking tibial nail. All fractures occured in young patients whose ages ranged from eighteen to twenty-nine years(mean, 24 years). We think the main reason of the fracture was characteristic design of ACE nail such as prominent distal angulation and posterior longitudinal slot. The other factors were age of the patient, material of the nail and timing of removal of the nail. In conclusion, we advise caution in the removal of the ACE reamed interlocking intramedullary tibial nail in young patient.
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Failure to Remove a Trochanteric Entry Femoral Nail and Its Cause in Adolescent Patients: Two Cases Report Ji-Hwan Kim, Seung-Oh Nam, Young-Soo Byun, Han-Sang Kim Journal of the Korean Fracture Society.2015; 28(1): 71. CrossRef