Short-term results for the management of distal tibial fractures by minimally invasive locked plating

Mohammad, Molham Mahmood; Halim Hafez, Khaled Mohamed Abdel; Abdelkader, Amr A.; Mohamed, Emad Gaber Kamel

doi:10.4103/1110-1148.154091

Short-term results for the management of distal tibial fractures by minimally invasive locked plating

Authors

Abstract

Background
Fractures of the distal tibia can be challenging to treat because of the limited soft tissue, the subcutaneous location, and poor vascularity. Minimally invasive locked plate aims to reduce surgical soft-tissue trauma and to help preserve periosteal blood supply and fracture hematoma and is useful in treating these challenging fractures.
Patients and methods
This study included 26 patients between 20 and 53 years of age (mean 34 years), with both open and closed distal tibial pilon fractures that were intra-articular or extra-articular. All fractures were fixed using minimally invasive plate osteosynthesis under image control using a precontoured locking compression plate–distal tibial plate.
Results
There were 11 AO 43 A, seven AO 43 B, and eight AO 43 C fractures including 18 closed and eight open fractures. Fracture union was achieved in 23 patients (88%), whereas three cases (12%) showed delayed union. Four cases suffered from late infection, and plate removal was necessary, whereas six cases had minor wound problems and responded to conservative treatment. Twenty-two patients (85%) returned to their work within 1 year of operation; however, 17 patients (65%) had not returned to their preinjury sporting or leisure activities. Seven patients (27%) had angular deformities, all less than 7°. The final ankle–hindfoot score was 84.8 points.
Conclusion
Short-term results for treating distal tibial pilon fractures using minimally invasive locked plate (locking compression plate–distal tibial plate) to reduce surgical soft-tissue trauma and to help preserve periosteal blood supply and fracture hematoma appears encouraging, with union rates similar to that of open reduction internal fixation (ORIF) techniques, but avoiding the usual associated drawbacks.

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