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Minimally invasive plate osteosynthesis yields low complication rates in distal tibial fracture management

Issue: Issue 6 2011

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DUBLIN — Minimally invasive plate osteosynthesis may be an effective treatment for distal tibial fractures, according a presenter here.

“We feel we have a safe and effective technique in the management of distal tibial fractures. Complications are infrequent and manageable,” S.K. Nanjayan said at the British Orthopaedic Association and the Irish Orthopaedic Association Combined Meeting 2011, here.

Nanjayan and his team conducted a retrospective study of 29 consecutive patients who had distal tibial fractures treated with minimally invasive plate osteosynthesis (MIPO) between 2004 and 2010. Mean patient age was 46 years, with a mean follow-up of 6.24 months. Radiographs and data, including demographics, fracture classification, complications and fracture healing were recorded in a database.

An anteromedial plate (Synthes) was used for all patients. There were 16 type A, one type B and 12 type C fractures under the AO classification. The Ruedi Allgower classification showed six group I fractures, five group II fractures and two group III fractures. No open fractures were included in the study, and five patients had temporary external fixation prior to MIPO.

Nanjayan reported that 28 patients had associated fibular fractures, of which six patients required open reduction and internal fixation through a separate surgical incision. There were no postoperative wound complications, and no malunion or intra-articular displacement were noted on radiographs.

Two patients had delayed union but went on to heal without secondary procedures, he said. Two patients had the plates removed due to significant metal prominence and tenderness.

Reference:

• Nanjayan SK, Deakin D, Milner S. Minimally invasive percutaneous plate osteosynthesis for distal tibial fractures. Paper #55. Presented at the British Orthopaedic Association and the Irish Orthopaedic Association Combined Meeting 2011. Sept. 13-16. Dublin.

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