Joon Soon Kang; Seung Rim Park; Sang Rim Kim; Yong Geun Park; Jae Ho Jung; Sung Wook Choi

doi:10.12671/jkfs.2010.23.2.172

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Original Article
The Comparison of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing in the Treatment of the Proximal and Distal Tibia Fracture: Joon Soon Kang, M.D., Seung Rim Park, M.D., Sang Rim Kim, M.D., Yong Geun Park, M.D., Jae Ho Jung, M.D., Sung Wook Choi, M.D.; Journal of the Korean Fracture Society 2010;23(2):172-179.
DOI: https://doi.org/10.12671/jkfs.2010.23.2.172
Published online: April 30, 2010

Department of Orthopedic Surgery, Inha University College of Medicine, Incheon, Korea.

^*Department of Orthopedic Surgery, Jeju National University College of Medicine, Jeju, Korea.

Address reprint requests to: Sung Wook Choi, M.D. Department of Orthopedic Surgery, Jeju National University Hospital, 1753-3, Ara-1-dong, Jeju 690-716, Korea. Tel: 82-64-717-1690, Fax: 82-64-757-8276, csw11@inha.com

• Received: February 13, 2009 • Revised: November 23, 2009 • Accepted: January 13, 2010

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Abstract
REFERENCES

Abstract

Purpose
To compare the efficacy of the surgical treatment through the comparison of Minimally Invasive Plate Osteosynthesis (MIPO) and Intramedullary (IM) nailing in the treatment of the tibial shaft fractures expended to metaphysis retrospectively.
Materials and Methods
Patients with proximal or distal third fracture of tibial shaft from May 2003 to Aug. 2006 were divided into two groups depending on the surgical method. Group A consisted of 30 patients treated with IM nailing, Group B was 29 patients treated with MIPO. The clinical outcomes were evaluated retrospectively from the time for bone union and callus formation confirmed by X-ray, functional score of knee or ankle joint, and complications including nonunion, malalignment and infection.
Results
Bone union was seen radiologically at a mean of 17.4 weeks in group A, and 17.0 weeks in group B. In postoperative complications, group A showed two nonunion, two delayed-union, six malalignment, and two wound infection while group B showed only one delayed-union and one wound infection.
Conclusion
There were no significant differences in the time for bony union and functional score between IM nailing and MIPO. Conventional IM nailing with only interlocking technique showed higher incidence of malalignment and deformity than MIPO for the treatment of the proximal or distal third fracture of the tibial shaft.
Key words: Tibial shaft fracture, Minimally invasive plate osteosynthesis, Intramedullary nailing

REFERENCES

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Fig. 1

(A) A 33 year-old man with a proximal tibial fracture was treated with intramedullary nailing. Postoperative AP and lateral radiographs at 6 months showed a nonunion of the fracture and valgus malalignment. The nonunion site was plated using traditional technique which involves dynamic compression plate and autogenous bone grafting.

(B) A 69 year-old man with a proximal tibial fracture was treated with intramedullary nailing. Postoperative AP and lateral radiographs at 12 months showed a nonunion of the fracture and valgus malalignment. The proximal tibial nonunion was treated with more thick intramedullary nailing and lateral unicortical plate in the state of limited open reduction.

Fig. 2

(A) Preoperative AP and lateral radiographs of the left ankle of a 50 year-old woman showed a distal tibial fracture (AO type 42, B2.2) with an associated fibular fracture. Postoperative AP and lateral radiographs at 22 weeks showed evidence of healing. The fibula was plated using traditional plating techniques in advance of an indirect reduction of the distal tibial fracture. The distal tibia was plated using minimally invasive technique.

(B) Preoperative AP and lateral radiographs of the right tibia of a 51 year-old woman showed a proximal tibial fracture after a traffic accident. Postoperative AP and lateral radiographs at 40 weeks showed a union of the fracture with good alignment after percutaneous plating with MIPO technique.

Table 1

Distribution of cases on the AO/OTA classification

^*IM nail: Intramedullary nail, ^†MIPO: Minimally invasive plate osteosynthesis.

Table 2

Comparison of IM nail and MIPO on the clinical outcome

^*IM nail: Intramedullary nail, ^†MIPO: Minimally invasive plate osteosynthesis.

Table 3

The data of complication cases

^*Distance: Distance between the adjacent joint (a knee joint or a ankle joint) line and the main fracture line (cm).

Table 4

Comparison of IM nail and MIPO on the functional score

IM nail: Intramedullary nail, ^†MIPO: Minimally invasive plate osteosynthesis.

Figure & Data

REFERENCES

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Effect of Korean Medicine Treatments in Patients with Proximal Tibia Fracture: A Retrospective Observational Study
Jung Min Lee, Eun-Jung Lee
Journal of Korean Medicine Rehabilitation.2020; 30(3): 141. CrossRef

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The Comparison of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing in the Treatment of the Proximal and Distal Tibia Fracture

J Korean Fract Soc. 2010;23(2):172-179. Published online April 30, 2010

DOI: https://doi.org/10.12671/jkfs.2010.23.2.172

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The Comparison of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing in the Treatment of the Proximal and Distal Tibia Fracture

Fig. 1 (A) A 33 year-old man with a proximal tibial fracture was treated with intramedullary nailing. Postoperative AP and lateral radiographs at 6 months showed a nonunion of the fracture and valgus malalignment. The nonunion site was plated using traditional technique which involves dynamic compression plate and autogenous bone grafting. (B) A 69 year-old man with a proximal tibial fracture was treated with intramedullary nailing. Postoperative AP and lateral radiographs at 12 months showed a nonunion of the fracture and valgus malalignment. The proximal tibial nonunion was treated with more thick intramedullary nailing and lateral unicortical plate in the state of limited open reduction.

Fig. 2 (A) Preoperative AP and lateral radiographs of the left ankle of a 50 year-old woman showed a distal tibial fracture (AO type 42, B2.2) with an associated fibular fracture. Postoperative AP and lateral radiographs at 22 weeks showed evidence of healing. The fibula was plated using traditional plating techniques in advance of an indirect reduction of the distal tibial fracture. The distal tibia was plated using minimally invasive technique. (B) Preoperative AP and lateral radiographs of the right tibia of a 51 year-old woman showed a proximal tibial fracture after a traffic accident. Postoperative AP and lateral radiographs at 40 weeks showed a union of the fracture with good alignment after percutaneous plating with MIPO technique.

Fig. 1

Fig. 2

The Comparison of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing in the Treatment of the Proximal and Distal Tibia Fracture

Table 1

Distribution of cases on the AO/OTA classification

^*IM nail: Intramedullary nail, ^†MIPO: Minimally invasive plate osteosynthesis.

Table 2

Comparison of IM nail and MIPO on the clinical outcome

^*IM nail: Intramedullary nail, ^†MIPO: Minimally invasive plate osteosynthesis.

Table 3

The data of complication cases

^*Distance: Distance between the adjacent joint (a knee joint or a ankle joint) line and the main fracture line (cm).

Table 4

Comparison of IM nail and MIPO on the functional score

IM nail: Intramedullary nail, ^†MIPO: Minimally invasive plate osteosynthesis.

Table 1 Distribution of cases on the AO/OTA classification

^*IM nail: Intramedullary nail, ^†MIPO: Minimally invasive plate osteosynthesis.

Table 2 Comparison of IM nail and MIPO on the clinical outcome

^*IM nail: Intramedullary nail, ^†MIPO: Minimally invasive plate osteosynthesis.

Table 3 The data of complication cases

^*Distance: Distance between the adjacent joint (a knee joint or a ankle joint) line and the main fracture line (cm).

Table 4 Comparison of IM nail and MIPO on the functional score

IM nail: Intramedullary nail, ^†MIPO: Minimally invasive plate osteosynthesis.