Evaluation of Results of Bridge Plating in Comminuted Fractures of Long Bones

Abstract

Osteosynthesis with open reduction technique in comminuted fracture has several disadvantages like increase rate of non-union, soft tissue problem, infection and implant failure. These problems may be overcome by percutaneous bridge plating technique which preserve the vascularity and soft tissue attachment of fracture fragments. MATERIALS AND METHODS: Twenty-five patients were involve in this study. All of twentyfive patients with closed comminuted diaphyseal fractures of femur (n-10) and tibia (n-15) were operated on using the principle indirect reduction and biological fixation with bridge plate under image intensifier. Partial and full weight bearing were allowed according to clinical and radiological union. RESULTS: Most regained excellent range of motion of knee and ankle. Mean time of radiological union was 20.12 weeks. Two patients had superficial skin problem which healed with local wound care. One patient had non union which was healed by bone grafting. In this study excellent result was seen in 18 cases, good in five and fair in two patients. CONCLUSION: Our study indicates that minimally invasive bridge plating is an effective alternative for treatment of comminuted diaphyseal fracture of long bones. These complex fractures give complete recovery of normal limb function at an early stage with less complication.

Clinical outcomes of minimal invasive plate osteosynthesis in comminuted fracture of long bones

“…Andalib et al [5] reported 1 (2%) patient of non-union in series of 49 cases underwent MIPO for comminuted fractures of long bones. In the study conducted by Mandal et al [4] , 1 patient (4%) had non-union in 25 cases of comminuted fracture of long bones treated with MIPO. Limb length discrepancy of less than 2.5 cm was present in 2 (7.69%) patients that is not so significant.…”

“…Early weight bearing resulted in implant failure. Mandal et al [4] reported 3 (12%) patients of restricted ROM in series of patient treated with MIPO in comminuted fracture of long bones. A total of 8 Postoperative complications were observed among the 26 patients followed up in our study.…”

“…Functional outcome and ROM of adjoining joint was assessed in all the patients as per the criteria laid down by Lam and Bromley [4] All the patients of tibia fracture had intact dorsiflexion and plantar flexion at ankle joint with no restriction in ROM at knee joint either. 3 patients of non-union had poor functional outcome as per criteria laid down by Lam and out of which one patient (7.69%) of comminuted fracture shaft femur-Distal diaphyseal and metaphyseal (AO 32 C 2type K) had restricted ROM at knee joint.…”