A Comparison between Minimally Invasive Plate Osteosynthesis & Interlocking Intramedullary Nailing in Distal Tibia Fractures

Kee-Byung Lee; Si-Young Song; Duek-Joo Kwon; Yong-Beom Lee; Nam-Kyou Rhee; Jun-Ha Choi

doi:10.12671/jkfs.2008.21.4.286

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Lee, Song, Kwon, Lee, Rhee, and Choi: A Comparison between Minimally Invasive Plate Osteosynthesis & Interlocking Intramedullary Nailing in Distal Tibia Fractures

Original Article

Journal of the Korean Fracture Society 2008; 21(4): 286-291.

Published online: 31 October 2008

DOI: https://doi.org/10.12671/jkfs.2008.21.4.286

A Comparison between Minimally Invasive Plate Osteosynthesis & Interlocking Intramedullary Nailing in Distal Tibia Fractures

Kee-Byung Lee, M.D., Si-Young Song, M.D., Duek-Joo Kwon, M.D., Yong-Beom Lee, M.D., Nam-Kyou Rhee, M.D., Jun-Ha Choi, M.D.

Department of Orthopedic Surgery, Hallym University Sacred Hospital, College of Medicine, Hallym University, Anyang, Korea.

Address reprint requests to: Si-Young Song, M.D. Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, 896, Pyeongan-dong, Dongan-gu, Anyang 431-796, Korea. Tel: 82-31-380-1814, Fax: 82-31-382-1814, sysong@hallym.or.kr

Received 10 February 2008 Revised 15 June 2008 Accepted 22 September 2008

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the effectiveness between minimally invasive plate osteosynthesis (MIPO) and interlocking IM nailing in the treatment of distal tibia fracture without involvement of ankle joint retrospectively.

Materials and Methods

38 patients with distal tibia fracture from Jan. 2004 to Oct. 2005 were divided into two groups. Minimum follow-up was for 12 months. Group MIPO consisted of 18 patients were treated with MIPO and group Nail consisted of 20 patients were treated with interlocking intramedullary nail. The results were compared between two groups by assessing bony union time and operation time. Clinical evaluation was evaluated by Olerud score.

Results

The mean bony union time was 14.4 weeks (12~17 weeks) in group MIPO and 16.7 weeks (13~19 weeks) in group Nail (p=0.011). The mean operation time was 1.05 hours (0.6~1.6 hours) in group MIPO and 0.74 hours (0.4~1.1 hours) in group Nail (p=0.044). The Olerud score was 83.8 (75~100) in group MIPO and was 89.6 (70~100) in group Nail (p=0.075). In Complication, group MIPO showed one metal failure and two skin irritations, group Nail showed three superficial wound infections.

Conclusion

MIPO was the shorter bony union time and the longer operation time than the interlocking intramedullary nailing. There were no significant differences between the two groups in clinical results.

Keywords: Distal tibia fracture, Minimally invasive plate osteosynthesis (MIPO), Interlocking intramedullary nailing

Figures and Tables

Fig. 1

(A) The initial radiographs of 60 year-old female show distal fracture without involvement of ankle joint (AP & Lateral view).

(B) The clinical photo shows the insertion of LCP DMP through subcutaneous tunnel of the distal tibia and fixation of the plate with screws.

(C) Bone union was obtained in 15 weeks after LCP DMP with interfragmentary fixation (AP & Lateral view).

Fig. 2

(A) The initial radiographs of 54 year-old male show distal fracture without involvement of ankle joint (AP & Lateral view).

(B) Bone union was obtained in 16 weeks after interlocking IM nail fixation (AP & Lateral view).

Fig. 3

The patient had a good bone union and excellent function, but complained skin irritation around medial aspect of ankle joint even if we used the Locking Compression Plate Distal Medial Tibia Plate (LCP DMT).

Table 1

Demographics of reported cases

^*MIPO: Minimally invasive plate osteosynthesis, ^†IM nailing: Intramedullary nailing

Table 2

Olerud score

Table 3

Results summary

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