Comparison of different locking plate fixation methods in distal tibia fractures

Abstract

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.

Reamed intramedullary exchange nailing in the operative treatment of aseptic tibial shaft nonunion

“…In recent literature, nonunion was the most prevalent complication of tibial shaft fractures and had been developed in up to 27 % of patients, independent of different fixation methods such as intramedullary nailing, locking compression plating, or external fixation [21][22][23][24]. Evidence comparing reamed with unreamed intramedullary nailing for closed tibial fractures indicates that reamed intramedullary nailing may lead to significantly lower risk for nonunion, screw failure, implant exchange, and dynamization without increasing operative complications [21,25], whereas the choice for open tibial fractures remains uncertain [26].…”

Comparison of suprapatellar versus infrapatellar approaches of intramedullary nailing for distal tibia fractures

“…Open reduction and internal fixation with plates and screws is the common method to treat distal tibia fractures [3][4][5]. However, plate fixation management of these fractures has often resulted in complications such as infections, delayed unions or nonunions, and implant failures [6][7][8]. In recent years, intramedullary nailing (IMN) and minimally invasive plate osteosynthesis (MIPO) have become common fixation methods for distal tibia fractures [9,10].…”

Comparison of suprapatellar versus infrapatellar approaches of intramedullary nailing for distal tibia fractures

“…Open reduction and internal xation with plates and screws is the common method to treat distal tibia fractures [3][4][5]. However, plate xation management of these fractures has often resulted in complications such as infections, delayed unions or nonunions, and implant failures [6][7][8]. In recent years, intramedullary nailing (IMN) and minimally invasive plate osteosynthesis (MIPO) have become common xation methods for distal tibia fractures [9,10].…”