Sung-Ki Park; Chang-Wug Oh; Jong-Keon Oh; Kyung-Hoon Kim; Woo-Kie Min; Byung-Chul Park; Won-Ju Jeong; Joo-Chul Ihn

doi:10.12671/jkfs.2010.23.3.289

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Staged Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures: Sung-Ki Park, M.D., Chang-Wug Oh, M.D., Jong-Keon Oh, M.D., Kyung-Hoon Kim, M.D., Woo-Kie Min, M.D., Byung-Chul Park, M.D., Won-Ju Jeong, M.D., Joo-Chul Ihn, M.D.; Journal of the Korean Fracture Society 2010;23(3):289-295.
DOI: https://doi.org/10.12671/jkfs.2010.23.3.289
Published online: July 31, 2010

Department of Orthopedic Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.

^*Department of Orthopedic Surgery, School of Medicine, Korea University, Seoul, Korea.

^†Department of Orthopedic Surgery, Daegu Veterans Hospital, Daegu, Korea.

Address reprint requests to: Chang-Wug Oh, M.D. Department of Orthopedic Surgery, School of Medicine, Kyungpook National University, 101, Dongin-dong 2-ga, Jung-gu, Deagu 700-422, Korea. Tel: 82-53-420-5630, Fax: 82-53-422-6605, cwoh@knu.ac.kr

• Received: October 17, 2009 • Revised: April 28, 2010 • Accepted: May 12, 2010

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Abstract
REFERENCES

Abstract

Purpose
To assess the result of staged minimally invasive plate osteosynthesis (MIPO) for distal tibial fracture with an open wound or injured soft tissue.
Materials and Methods
In 20 patients (mean age, 47.8 year-old) with distal tibial fractures, there were 4 type A fractures and 16 type C fractures based on the AO classification system. Eight of the 20 patients had open fractures. MIPO was performed on average 23.9 days after bridging external fixation. At the final follow-up, we assessed the radiological results of bone union and alignment. Functional results were also evaluated by measuring the degrees of ankle motion and the American Orthopedic Foot & Ankle Society (AOFAS) scores.
Results
Seventeen of 20 cases (85%) achieved primary union at an average of 21.3 weeks. There were 3 cases of nonunion requiring a bone graft. The mean AOFAS score was 88.5 (range, 67~92) and the average range of ankle motion was 49.2° (plantarflexion: 37.4°, dorsiflexion: 11.8°). Complication included 2 cases of minor mal-alignment, 1 case of claw toe and 1 case of peroneal neuropathy. Patients over the age of 60 had lower functional results. Additional factors did not affect the final results.
Conclusion
Staged MIPO may achieve satisfactory results in distal tibial fractures with soft tissue compromise, decreasing deep infections and soft tissue complications.
Key words: Distal tibial fracture, External fixation, Minimally invasive plate osteosynthesis

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Fig. 1

(A) A 48-year old man sustained the distal tibial fracture with grade IIIA open wound.

(B) After fixation of fibula fracture, bridging external fixation was done with wound debridement and closure.

(C, D) After the improvement of soft tissue condition, medial plating was done with minimally invasive technique.

(E) At 6 month, a successful union was achieved with the good alignment.

Fig. 2

(A) An AO-OTA 43-C2 fracture.

(B) A bridging external fixation was applied.

(C, D) After the improvement of soft tissue condition, medial MIPO was done with joint reconstruction.

(E) A successful healing was achieved after 8 months.

Table 1

Distal tibial fractures treated with staged MIPO technique

^*TA: Traffic accident, ^†AO/OTA: Arbeitsgemeinschaft für Osteosynthesefragen and orthopedic trauma association, ^‡Ex-Fix: External fixator, ^§DMT: LCP distal medial tibia, ^∥ALDT: LCP Anterolateral distal tibia plate, ^¶PP-ADT: Periarticular anterolateral distal tibia plate, ^**ROM: Range of motion, ^††AOFAS: American orthopedic foot and ankle society.

Figure & Data

REFERENCES

Citations

Citations to this article as recorded by

Anterolateral Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures Using an Anterolateral Locking Plate
Dongwhan Suh, Hwan Hee Lee, Young Hoon Han, Jae Jung Jeong
Journal of Korean Foot and Ankle Society.2020; 24(1): 19. CrossRef
Minimally Invasive Osteosynthesis with Locking Compression Plate for Distal Tibia Fractures
Sung-Kyu Kim, Keun-Bae Lee, Keun-Young Lim, Eun-Sun Moon
Journal of the Korean Fracture Society.2011; 24(1): 33. CrossRef

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Staged Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures

J Korean Fract Soc. 2010;23(3):289-295. Published online July 31, 2010

DOI: https://doi.org/10.12671/jkfs.2010.23.3.289

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Staged Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures

Fig. 1 (A) A 48-year old man sustained the distal tibial fracture with grade IIIA open wound. (B) After fixation of fibula fracture, bridging external fixation was done with wound debridement and closure. (C, D) After the improvement of soft tissue condition, medial plating was done with minimally invasive technique. (E) At 6 month, a successful union was achieved with the good alignment.

Fig. 2 (A) An AO-OTA 43-C2 fracture. (B) A bridging external fixation was applied. (C, D) After the improvement of soft tissue condition, medial MIPO was done with joint reconstruction. (E) A successful healing was achieved after 8 months.

Fig. 1

Fig. 2

Staged Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures

Table 1

Distal tibial fractures treated with staged MIPO technique

Table 1 Distal tibial fractures treated with staged MIPO technique