Minimally Invasive Osteosynthesis with Locking Compression Plate for Distal Tibia Fractures

Sung-Kyu Kim; Keun-Bae Lee; Keun-Young Lim; Eun-Sun Moon

doi:10.12671/jkfs.2011.24.1.33

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Kim, Lee, Lim, and Moon: Minimally Invasive Osteosynthesis with Locking Compression Plate for Distal Tibia Fractures

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2011; 24(1): 33-40.

Published online: 19 January 2011

DOI: https://doi.org/10.12671/jkfs.2011.24.1.33

Minimally Invasive Osteosynthesis with Locking Compression Plate for Distal Tibia Fractures

Sung-Kyu Kim, M.D., Keun-Bae Lee, M.D., Ph.D., Keun-Young Lim, M.D., Eun-Sun Moon, M.D., Ph.D.

Department of Orthopedic Surgery, Chonnam National University Medical School and Hospital, Gwangju, Korea.

Address reprint requests to: Keun Bae Lee, M.D., Ph.D. Department of Orthopedic Surgery, Chonnam National University Medical School and Hospital, 8, Hak-dong, Dong-gu, Gwangju 501-757, Korea. Tel: 82-62-220-6336·Fax: 82-62-225-7794, kbleeos@chonnam.ac.kr

Received 25 November 2010 Accepted 2 December 2010

(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 evaluate the outcome of minimally invasive osteosynthesis using locking compression plate for distal tibia fractures.

Materials and Methods

Forty five patients (45 cases) who underwent minimally invasive osteosynthesis using locking compression plate for distal tibia fractures between January 2006 and June 2008, were followed for more than one year. The average duration of the follow-up was 30.5 months (12~54 months). The fracture types were as followed: 26 cases (58%) of extraarticular fractures, 19 cases (42%) of intraarticular fractures, and 16 cases (36%) of open fractures.

Results

All patients achieved bone union at average of 21weeks (12~36 weeks). The average American Orthopedic Foot & Ankle Society ankle-hindfoot scales was 84.6 points (65~100 points) and range of ankle motion averaged at 46.5 degrees (20~60 degrees). Complications included 6 cases of superficial infection, 3 cases of malalignment and 5 cases of skin irritation by plate. There were no cases of deep infection, skin necrosis, shortening and metal breakage.

Conclusion

Minimally invasive osteosynthesis using locking compression plate for distal tibia fractures is considered to be an effective method with high healing rate, rapid functional recovery and low complication rate due to minimal disruption of bone and soft tissue biology and improved fixation strength.

Keywords: Distal tibia fracture, Locking compression plate, Minimally invasive osteosynthesis

Figures and Tables

Fig. 1

(A~C) Preoperative radiographs and 3-dimensional computed tomography of a 39 year-old man shows a distal tibia and fibular fractures classified as the AO/OTA type C2.

(D) The operation was delayed 5 days because of severe soft tissue swelling.

(E, F) The distal tibia fracture was stabilized with the LCP metaphyseal plate using minimal invasive technique.

(G, H) Postoperative radiographs shows successful union with a good alignment at 14 months after surgery.

Fig. 2

(A) A 50 year-old man sustained distal tibia and fibular fractures classified as the AO/OTA type C2.

(B) Immediate postoperative anteroposterior radiograph shows 13 degrees of valgus malalignment.

(C) At 4 months postoperatively, radiograph shows bone union.

(D) At 17 months postoperatively, patient had good functional outcome without further progression of valgus malalignment.

Table 1

Demographic data

^*AO/OTA: Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association, ^†According to Gustilo-Anderson classification.

Table 2

Literature review on outcomes of minimally invasive osteosynthesis with locking compression plate for distal tibia fractures

^*AO: Arbeitsgemeinschaft für Osteosynthesefragen, ^†LCP-DT: Locking compression plate-distal tibia.

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