Absolute or relative stability in minimal invasive plate osteosynthesis of simple distal meta or diaphyseal tibia fractures?

被引:22
|
作者
Wenger, R. [1 ,2 ]
Oehme, F. [1 ]
Winkler, J. [1 ]
Perren, S. M. [3 ]
Babst, R. [1 ]
Beeres, F. J. P. [1 ]
机构
[1] Cantonal Hosp Lucerne, Dept Orthopaed & Trauma Surg, Spitalstr, CH-6000 Luzern, Switzerland
[2] Cantonal Hosp St Gallen, Dept Hand Plast & Reconstruct Surg, Rorschacher Str 95, CH-9007 St Gallen, Switzerland
[3] Dischmastr 22, CH-7260 Davos, Switzerland
关键词
Tibia fracture; Locking compression plate; Bridge plating; Lag screw; Minimal invasive plate osteosynthesis; LOCKING COMPRESSION PLATE; METAPHYSEAL FRACTURES; FEMUR FRACTURES; SCREW FIXATION; OPEN REDUCTION; EPIDEMIOLOGY; GUIDELINES; STIFFNESS;
D O I
10.1016/j.injury.2017.03.005
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Introduction: Minimal invasive plate osteosynthesis in simple distal meta or diaphyseal tibia fractures can be applied using absolute (lag screw and neutralisation plate; LSN) or relative stability (bridge plate; BP). The primary aim of the study was to compare time to radiological union and time to full weight bearing in the two groups (LSN vs. BP). Reduction was performed either percutaneously or by a minimally open approach (mini open). Secondary aim was to analyse the number of complications between both groups. Methods: Retrospective single centre review of patients with a simple distal meta or diaphyseal tibia fracture operated with a Locking Compression Plate (LCP) between 2009 and 2015 in a Level one Trauma Centre. Postoperative radiographs were assessed in a standardised manner. Time to radiological fracture union and time to full weight bearing were observed. Callus index and postoperative complications were analysed. Results: Fifty-seven patients with a minimum follow-up of 6 months were analysed. Forty-eight patients had a shaft (AO/OTA Type 42) and nine a distal tibia fracture (AO/OTA Type 43). Forty patients were treated with using the LSN concept and 17 patients with the BP concept. Median time to radiological fracture union was statistically significant shorter (p = 0.04) in the LSN group with 19 weeks compared to 27 weeks in the BP-group. Time to full weight bearing was 10 weeks in both groups. A total (including implant removal) of 35 reoperations were performed in the LSN-group and 18 in the BP-group. Wound healing disorders (deep surgical site infections) were seen less the LSN group in 3/40 (7.5%) compared to the BP-group with 3/17 (17.6%). In the LSN group, there was no statistical difference in time to union or weight bearing between a percutaneous or mini open approach. Conclusion: Stable osteosynthesis of simple distal meta or diaphyseal tibia fractures leads to faster radiologic fracture healing without an increase in complications or number of revisions compared to bridge plating. If a percutaneous reduction is not feasible for the insertion of a lag screw, a mini-open approach does not lead to a delay in fracture healing. (C) 2017 Elsevier Ltd. All rights reserved.
引用
收藏
页码:1217 / 1223
页数:7
相关论文
共 50 条
  • [1] Minimally invasive plate osteosynthesis of distal fractures of the tibia
    Helfet, DL
    Shonnard, PY
    Levine, D
    Borrelli, J
    INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 1997, 28 : SA42 - SA48
  • [2] Minimally Invasive Plate Osteosynthesis for Distal Tibia Fractures
    Lai, Ted C.
    Fleming, Justin J.
    CLINICS IN PODIATRIC MEDICINE AND SURGERY, 2018, 35 (02) : 223 - +
  • [3] Fractures of the distal tibia: minimally invasive plate osteosynthesis
    Redfern, DJ
    Syed, SU
    Davies, SJM
    INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2004, 35 (06): : 615 - 620
  • [4] PLATE OSTEOSYNTHESIS OF CLOSED DIAPHYSEAL FRACTURES OF THE TIBIA
    SCHMITNEUERBURG, KP
    ORTHOPADE, 1984, 13 (04): : 271 - 286
  • [5] Wound complication of minimally invasive plate osteosynthesis in distal tibia fractures
    Lau, T. W.
    Leung, F.
    Chan, C. F.
    Chow, S. P.
    INTERNATIONAL ORTHOPAEDICS, 2008, 32 (05) : 697 - 703
  • [6] Treatment of distal tibia end fractures by minimally invasive plate osteosynthesis
    Quang-Tri Le
    Ngoc-Thanh Do
    Minh-Hoang Nguyen
    Huu-Hung Phan
    ANNALS OF CLINICAL AND ANALYTICAL MEDICINE, 2020, 11 : 33 - 36
  • [7] Outcomes of Minimally Invasive Plate Osteosynthesis for Metaphyseal Distal Tibia Fractures
    Collinge, Cory
    Protzman, Robert
    JOURNAL OF ORTHOPAEDIC TRAUMA, 2010, 24 (01) : 24 - 29
  • [8] Minimally Invasive Plate Osteosynthesis with Locking Plates for Distal Tibia Fractures
    Dhakar, Ajeet
    Annappa, Rajendra
    Gupta, Mahesh
    Harshwardhan, Hemeshwar
    Kotian, Prem
    Suresh, Pooja K.
    JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2016, 10 (03) : RC1 - RC4
  • [9] Wound complication of minimally invasive plate osteosynthesis in distal tibia fractures
    T. W. Lau
    F. Leung
    C. F. Chan
    S. P. Chow
    International Orthopaedics, 2008, 32
  • [10] Minimally invasive plate osteosynthesis (MIPO) in proximal and distal fractures of the tibia
    Sirbu, P. D.
    Mihaila, R. I.
    Ghionoiu, G.
    Bruja, R.
    Asaftei, R.
    PROCEEDINGS OF THE 7TH EUROPEAN TRAUMA CONGRESS, 2006, : 349 - +