Medial versus lateral plating in distal tibial fractures: A prospective study of 40 fractures

Encinas-Ullán, Carlos A.; Fernández-Fernández, Ricardo; Rubio-Suárez, Juan Carlos; Gil-Garay, E.

doi:10.1016/j.recote.2012.11.001

Cited by 7 publications

(6 citation statements)

References 28 publications

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“…It might be that high rate of problems with bone union in this group was related not only to type of surgical approach and plate used, but also to energy and extent of injury. To sum up, factors that have influence on choice of approach and type of fixation in pilon fractures are type of fracture and condition of soft tissue [16,17].…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…Vorteil ist zudem die exzellente Visualisierung der tibialen Gelenkfläche. Ein statistischer Unterschied zwischen dem anteromedialen und anterolateralen Zugang bezüglich Knochenbruchheilung, Pseudarthrosenbildung und Infektionsrate konnte nicht nachgewiesen werden [7]. Vervollständigt wird die Variation der Zugänge durch den posteromedialen und den posterolateralen Zugang [24,25].…”

Section: Operationszugängeunclassified

“…Ausbehandlung im Fixateur externe Die Verwendung einer Platte ist aufgrund der Weichgewebssituation in Einzelfällen nicht empfehlenswert. Hier kann die Ausbehandlung im Fixateur externe trotz drohender bewegungseinschränkender Kontrakturen und vermehrter Schmerzen erfolgen [7]. Sie kommt z.…”

Section: Alternative Behandlungsmöglichkeitenunclassified

“…Kanten-oder Fragmentausbrüche wie die Fraktur des hinteren Volkmann-Dreiecks oder auch die Tubercule-de-Chaput-Verletzungen werden ebenso wie die Malleolenfrakturen nicht den Pilonfrakturen zugerechnet [4]. In über 80% der Fälle kommt es neben der Pilonfraktur zu einer begleitenden Fraktur der distalen Fibula [1,[5][6][7]. Diese Begleitverletzung kann einen Hinweis auf die Schwere der Trümmerfraktur des Pilons geben.…”

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Pilonfrakturen

2015

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Pilon fractures are uncommon, representing approximately 5-10 % of all lower limb fractures. Pilon fractures are often associated with serious soft tissue injuries resulting in initial external fixation followed by internal fixation once the condition of the soft tissues has improved. Articular distal fractures of the tibia are classified as B3, C1, C2 and C3 fractures according to the AO Classification. Pilon fractures are usually the result of a high energy trauma. A low energy trauma such as a twisting injury of the ankle can also lead to a pilon fracture. Such low energy mechanisms of injury are rarely associated with significant soft tissue injury and can be immediately fixated internally. Pilon fractures are often associated with an unsatisfactory healing response. This is a result of a combination of factors including the severity of the trauma, the extent of the initial soft tissue injury and the accuracy of the articular surface reconstruction.

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“…Yenna's group simulated tibial loading and found no significant difference in mean stiffness between medial and lateral plates [17]. Encinas-Ullan and colleagues conducted a prospective study of 40 patients treated with medial versus lateral plating and found no statistical differences between groups regarding time to union and infection rates [18].…”

Section: Introductionmentioning

confidence: 99%

Distal tibia fractures and medial plating: factors influencing re-operation

Sathiyakumar

Thakore

Ihejirika-Lomedico

et al. 2014

International Orthopaedics (SICOT)

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There was a high re-operation rate associated with distal tibia medial plating, with significant differences in the reason for re-operation between open versus closed groups. Complication rates were not influenced by the use of locking plates. Results of this study suggest that methods be considered to reduce re-operation based on type of fracture, such as early bone grafting or the use of alternate implants for open fractures.

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Medial versus lateral plating in distal tibial fractures: A prospective study of 40 fractures

Cited by 7 publications

References 28 publications

Comparison of different locking plate fixation methods in distal tibia fractures

Comparison of different locking plate fixation methods in distal tibia fractures

Pilonfrakturen

Distal tibia fractures and medial plating: factors influencing re-operation

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