THE CHETTINAD EXPERIENCE WITH FIXED-ANGLE LOCKING PLATE FIXATION FOR FRACTURES OF DISTAL TIBIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2015, Vol 4, Issue 25
Abstract
The Surgical treatment of fractures of the distal tibia poses a true challenge to the Orthopaedic Surgeon because of the paucity of soft tissue, their subcutaneous location and poor vascularity. The complications related to treatment are also high. The fixation options are many. Recently, the locking plate has become a surgeon friendly implant in the treatment of complex fractures of the distal part of the tibia. Locking plates have the properties of both internal and external fixators and offer fixed angular stability through the head of locking screws. [b]AIM:[/b] The purpose of this retrospective study was to assess the results of plate osteosynthesis using fixed-angle pre-contoured distal medial tibial locking plate (LCP) as a method of treating juxta-articular and intra-articular fractures of distal tibia. [b]MATERIALS AND METHODS[/b]: This study was performed at the Department of Orthopaedic Surgery, Chettinad Hospital and Research Institute, IT Highway, Kelambakkam. Fractures in skeletally mature patients involving the distal metaphysis of the tibia requiring stability in sagittal or coronal plane with or without intra-articular extension were studied. From November 2012 to August 2013, 15 patients with distal tibial fractures were treated with a fixed-angle locking plate. There were 11 male and 4 female patients with an average age of 34. 8 years (range, 20–67 years). The average follow-up was 12 months. The mechanism of injury included motor vehicle accidents (n=10), fall (n=3) and industrial accident (n=2). [b]RESULTS[/b]: All fractures healed at an average time of 14 weeks (range, 10–18 weeks). Ankle final ranges of motion averaged 17° dorsiflexion (range, 0°-25°) and 34° plantar flexion (range, 20°-40°). All fractures healed with satisfactory alignment. There were 6 postoperative complications. The limitations in this study are its retrospective nature, small sample size and a short follow-up of one year. [b]CONCLUSION[/b]: Our results show that the fixed angle locking plate provides a high degree of stability to very short segments of distal tibia, achieves high fracture union rates and with limited complications. Therefore, distal tibial LCP can be a reasonably suitable implant in the surgical treatment of fractures of distal tibia with or without intra-articular extension and with short metaphyseal segments.
Authors and Affiliations
Chander S. G, Kanagasarthy K, Balaji Govindarajan, Narayana Reddy
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