Are locking plates better than non-locking plates for treating distal tibial fractures?

Bastías, Christian; Henríquez, Hugo; Pellegrini, Manuel J.; Rammelt, Stefan; Cuchacovich, Natalio; Lagos, Leonardo; Carcuro, Giovanni

doi:10.1016/j.fas.2013.12.004

Cited by 13 publications

(10 citation statements)

References 26 publications

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“…Finally, the average score for the physical component of the SF-36v2 of the patients in our sample (44.17 points) was compared with the average score of the same index of the Italian population (50 points) [ 16 ]. In the literature, some studies have found similar results, getting even lower scores when taking into account only the most serious fractures [ 18 , 20 – 23 ].…”

Section: Discussionmentioning

confidence: 80%

Medium-Long-Term Radiographic and Clinical Outcomes after Surgical Treatment of Intra-Articular Tibial Pilon Fractures by Three Different Techniques

Biz

Angelini

Zamperetti

et al. 2018

BioMed Research International

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Introduction The goal of this retrospective, observational, case series study was to evaluate the medium-long-term clinical and radiographic results of the three most common surgical osteosynthesis techniques used for the treatment of articular tibial pilon fractures: ORIF, MIPO, and EF. Materials and Methods A consecutive series of patients with articular pilon fractures who underwent surgery at our institution were enrolled in this study. Fractures were classified according to the Müller AO classification system. Overall outcomes took the following into account: radiographic quality of reduction, evaluated using Ovadia and Beals' criteria; clinical assessment, evaluated using the AOFAS questionnaire; and general health, evaluated with the SF36-v2 Health Survey. Results A total of 94 articular pilon fractures (34 type 43-B and 60 43-C) were evaluated with a mean follow-up of 56.34 months (range 33–101). The techniques used were ORIF, MIPO, and EF in 63 (67%), 17 (18.9%), and 14 cases (14.1%), respectively. According to Ovadia and Beals' criteria, good, fair, and poor results were reported in 61 (64.89%), 26 (27.66%), and 7 (7.45%) cases, respectively. The mean AOFAS score was 82.41 for MIPO, 79.83 for ORIF, and 50.57 for EF, respectively. Thirty-nine patients (41.49%) presented early and/or late complications. Conclusion Satisfactory outcomes using the three different techniques were reported. In particular, the radiographic outcomes were inversely proportional to the fracture comminutions and statistically different between internal and external osteosynthesis, but comparable between ORIF and MIPO techniques. On the other hand, the clinical outcomes were closely related to the soft tissue conditions and the anatomical reconstruction of the joint.

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Section: Discussionmentioning

confidence: 80%

Medium-Long-Term Radiographic and Clinical Outcomes after Surgical Treatment of Intra-Articular Tibial Pilon Fractures by Three Different Techniques

Biz

Angelini

Zamperetti

et al. 2018

BioMed Research International

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“…It is now postulated that surgical treatment should be held in stages according to the rules of damage control orthopaedics. Moreover, development of implants with angular stability and less invasive stabilization techniques gives us hope of acquiring better mid-and long-term results [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Comparison of different locking plate fixation methods in distal tibia fractures

Piątkowski

Piekarczyk

Kwiatkowski

et al. 2015

International Orthopaedics (SICOT)

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Purpose The aim of our study was to assess the outcome of locking plate fixation of distal tibia fractures and evaluate which surgical approach and method of plate fixation is related to better functional result and lower complication rate. Methods A retrospective analysis of treatment of 45 patients was made. Patients were divided into two subgroups regarding surgical approach (medial vs anterior) and fixation method (bridge plating vs rigid fixation). Time from injury to full bone union was noted, and clinical outcome was assessed by AOFAS score. Results Nonunion was the most prevalent complication and was observed in 26.6 % of patients. Infection rate was 11.1 %. Higher rate of bone union complications was noted in the anterior approach group with anterolateral anatomical plate. Infection and re-operation rates were similar in all subgroups. There were no correlations between fracture extension, length of plate and screw placement with bone healing time and AOFAS score. Conclusions Outcome of plate fixation of distal tibia fracture did not depend on the fixation method or surgical approach but, when possible, the medial plating via MIPO technique is a favourable method of treatment.

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“…1D). In order to theoretically improve the strength of the internal fixation system, the thickness of the plates (~6 mm) was larger than that of the traditional plates 19 (~4.5 mm) used in repairing the proximal tibia or distal femur fractures. In the 3D view, the required number, location and length of screws were determined preoperatively following the simulated surgical procedure (Fig.…”

Section: Methodsmentioning

confidence: 99%

3D printed personalized titanium plates improve clinical outcome in microwave ablation of bone tumors around the knee

Zhu

et al. 2017

Sci Rep

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Microwave ablation has been widely accepted in treating bone tumor. However, its procedure is time-consuming and usually results in postoperative fractures. To solve this problem, we designed and fabricated titanium plates customized to the patients’ bone structures. The personalized titanium plates were then used for fixation after the removal of tumorous tissue. Specifically, 3D models of tumor-bearing bone segments were constructed by using computed tomography (CT) and magnetic resonance imaging (MRI). The 3D models were used to design the personalized titanium plates. The plate model was transferred into a numerical control machine for manufacturing the personalized titanium plates by 3D printing. The plates were then surgically implanted for reconstruction assistance following microwave-induced hyperthermia to remove the bone tumor. Implementation parameters and knee functions were then evaluated. No postoperative fractures, implant failures or loosening problems occurred; mean Musculoskeletal Tumor Society score was 27.17 from the latest follow-up. Mean maximum flexion of affected knees was 114.08°. The results of knee gait analysis were comparable with normal population data. Our work suggests that personalized titanium plates can significantly improve the clinical outcomes in the surgical removal of bone tumor. This study represents the first-time effort in using personalized titanium plates for such surgery.

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Are locking plates better than non-locking plates for treating distal tibial fractures?

Cited by 13 publications

References 26 publications

Medium-Long-Term Radiographic and Clinical Outcomes after Surgical Treatment of Intra-Articular Tibial Pilon Fractures by Three Different Techniques

Medium-Long-Term Radiographic and Clinical Outcomes after Surgical Treatment of Intra-Articular Tibial Pilon Fractures by Three Different Techniques

Comparison of different locking plate fixation methods in distal tibia fractures

3D printed personalized titanium plates improve clinical outcome in microwave ablation of bone tumors around the knee

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