Minimally Invasive Plate Osteosynthesis in Metaphyseal Fracture of Tibia and Femur

Abstract

BACKGROUNDMetaphyseal fractures of long bones of lower limb are difficult to manage. In our study, we have evaluated the radiological and functional outcome of minimally invasive plate osteosynthesis (MIPO) technique for metaphyseal fracture of femur and tibia. MATERIALS AND METHODSA total of 37 metaphyseal fractures of long bone of lower limb were included in the study. The fractures were treated with minimal incisions, both at proximal and distal ends of plate. The anatomical metaphyseal locking plate was then inserted subperiosteally and the fracture was bridged after which the plate was fixed. The patients were followed up and the progresses were evaluated at regular interval by Johner-Wruhs' criterion and lower extremity functional score. RESULTSAll the fractures united well. The mean time of union of distal femur, proximal and distal tibia are 18 (range 14 -24), 18 (range 14 -22) and 17 (range 16 -24) weeks respectively. The mean range of motion at knee of fracture around knee was 105°, while for fracture at ankle the range of motion was a mean dorsiflexion of 19° and mean 30° plantar flexion. According to Johner-Wruhs' criterion results were excellent in 14, good in 17, fair in 5 and poor in 1 patient. By LEFS system, 34 patients have no difficulty in doing their work, while only 3 patients have a little bit of difficulty. No patients required bone grafting. The complication rates were also low. CONCLUSIONFor metaphyseal fractures, MIPO can be regarded as an optimal treatment modality which achieves good bone union and functional results with minimum soft tissue damage.

Minimally Invasive Percutaneous Plate Osteosynthesis technique combined with locking compression plates guided by C-Arm X-Ray machine in treatment of tibial metaphyseal fractures: Curative effect and postoperative complications

“… Patients who met the diagnostic criteria of tibial metaphyseal fracture 8 ; Patients with fresh fractures; Oatients who aged >18 years old; and Patients with complete clinical data. …”