Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Clinical Features of Distal Tibial Fractures and Treatment Results of Minimally Invasive Plate Osteosynthesis

원위 경골 골절의 임상양상 및 최소 침습적 금속판 고정술의 결과

  • Kim, Weon-Yoo (Department of Orthopedic Surgery, The Catholic University of Korea, Daejeon St. Mary's Hospital) ;
  • Ji, Jong-Hun (Department of Orthopedic Surgery, The Catholic University of Korea, Daejeon St. Mary's Hospital) ;
  • Kwon, Oh-Soo (Department of Orthopedic Surgery, The Catholic University of Korea, Daejeon St. Mary's Hospital) ;
  • Park, Sang-Eun (Department of Orthopedic Surgery, The Catholic University of Korea, Daejeon St. Mary's Hospital) ;
  • Kim, Young-Yul (Department of Orthopedic Surgery, The Catholic University of Korea, Daejeon St. Mary's Hospital) ;
  • Kil, Ho-Jin (Department of Orthopedic Surgery, The Catholic University of Korea, Daejeon St. Mary's Hospital) ;
  • Jeong, Jae-Jung (Department of Orthopedic Surgery, The Catholic University of Korea, Daejeon St. Mary's Hospital)
  • 김원유 (가톨릭대학교 의과대학 대전성모병원 정형외과학교실) ;
  • 지종훈 (가톨릭대학교 의과대학 대전성모병원 정형외과학교실) ;
  • 권오수 (가톨릭대학교 의과대학 대전성모병원 정형외과학교실) ;
  • 박상은 (가톨릭대학교 의과대학 대전성모병원 정형외과학교실) ;
  • 김영율 (가톨릭대학교 의과대학 대전성모병원 정형외과학교실) ;
  • 길호진 (가톨릭대학교 의과대학 대전성모병원 정형외과학교실) ;
  • 정재중 (가톨릭대학교 의과대학 대전성모병원 정형외과학교실)
  • Received : 2012.03.29
  • Accepted : 2012.05.16
  • Published : 2012.06.15
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Abstract

Purpose: The purpose of this study is to analyze the clinical features of distal tibia fractures and to evaluate the treatment outcomes of minimally invasive plate osteosynthesis (MIPO). Materials and Methods: From January 2004 to December 2009, 84 cases of 81 patients treated with plate fixation for distal tibia fracture were enrolled in this retrospective review. We investigated age, sex, injury mechanism, fracture patterns, and complications, and the clinical features were analyzed. To evaluate the treatment outcomes of MIPO, we divided into two groups. MIPO group consisted of 55 patients were treated with MIPO technique and conventional group consisted of 18 patients were treated with open reduction and internal fixation with conventional anterolateral plating. The results were compared between two groups by assessing bony union time, operation time, amount of blood loss, range of ankle motion, clinical score by American Orthopaedic Foot and Ankle Society (AOFAS) score, and post-operative complications. Results: The mean age of 81 patients with distal tibia fracture was 54.8 years. According to AO classification, A1:2:3 were 16, 20, 16 patients, B1:2:3 were 2, 8, 7, C1:2:3 were 1, 3, 11 patients. According to injury mechanism, slip down injury was patients, traffic accident was 26, fall from height injury was 14 patients respectively. The type A fractures were lower energy trauma and more older patients. The type C fractures were higher energy trauma and younger patients. MIPO group was better than conventional group in operative time, blood loss, bony union time, and ankle joint motion. In complications, MIPO group showed no nonunion and infection, one malunion, one skin necrosis, nine skin irritations, and one screw breakage. Conventional group showed two nonunion, four infections, two skin necrosis, and one metal failure. Conclusion: Distal tibial fractures caused by low energy trauma were on the increase. Minimal invasive plate osteosynthesis was shorter bony union time and operation time, less blood loss, and larger ankle motions than conventional open reduction and plate fixation.

Keywords

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