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KMID : 0386420100230030289
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Journal of the Korean Fracture Society
2010 Volume.23 No. 3 p.289 ~ p.295
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Staged Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures
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Park Seung-Ki
Oh Chang-Wug
Min Woo-Kie
Park Byung-Chul
Ihn Joo-Chul
Oh Jong-Keon
Kim Kyung-Hoon
Jeong Won-Ju
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Abstract
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Purpose: To assess the result of staged minimally invasive plate osteosynthesis (MIPO) for distal tibial fracture with an open wound or injured soft tissue.
Materials and Methods: In 20 patients (mean age, 47.8 year-old) with distal tibial fractures, there were 4 type A fractures and 16 type C fractures based on the AO classification system. Eight of the 20 patients had open fractures. MIPO was performed on average 23.9 days after bridging external fixation. At the final follow-up, we assessed the radiological results of bone union and alignment. Functional results were also evaluated by measuring the degrees of ankle motion and the American Orthopedic Foot & Ankle Society (AOFAS) scores.
Results: Seventeen of 20 cases (85%) achieved primary union at an average of 21.3 weeks. There were 3 cases of nonunion requiring a bone graft. The mean AOFAS score was 88.5 (range, 67∼92) and the average range of ankle motion was 49.2o (plantarflexion: 37.4o, dorsiflexion: 11.8o). Complication included 2 cases of minor mal-alignment, 1 case of claw toe and 1 case of peroneal neuropathy. Patients over the age of 60 had lower functional results. Additional factors did not affect the final results.
Conclusion: Staged MIPO may achieve satisfactory results in distal tibial fractures with soft tissue compromise, decreasing deep infections and soft tissue complications.
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KEYWORD
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Distal tibial fracture, External fixation, Minimally invasive plate osteosynthesis
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