Percutaneous Minimally Invasive Plate Osteosynthesis in Distal Tibial Fracture

Authors

Keywords:

distal tibia, trauma to the tibia, extra-articular fracture, DCP board, biological osteosynthesis

Abstract

Introduction: Diaphyseal fractures of the tibia have high incidence per year, including those of the distal third. They are the most common of the long bones and are seen mostly in young adults. They are generally caused by high-energy trauma such as traffic accidents and falls from heights. 

Objective: To present the results of the treatment on a patient with extraarticular fracture of the distal third of the tibia, using minimally invasive percutaneous osteosynthesis technique.

Case report: A white 45-year-old male patient was injured in a traffic accident, and he was treated in the Orthopedics and Traumatology service at Dr. Antonio Luaces Iraola General Teaching Hospital, because of a trauma to his left leg. He had pain, swelling and inability to walk. Physical examination revealed pain, deformity, crepitus, abnormal mobility, increased volume, and absolute functional impotence. X-rays were performed. The diagnosis was confirmed, and surgical treatment was decided with a minimally invasive percutaneous technique. The principles of biological osteosynthesis were followed and a second generation plate of AO system was used.

Conclusions: The surgical time was 45 minutes. The hospital stay was 48 hours. Partial support of the leg was started at eight weeks, and full support at 15 weeks. Full fracture healing was achieved 16 weeks after surgery, the procedure was evaluated as excellent according to the American Orthopedic Foot and Ankle Society (AOFAS) score.

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References

REFERENCIAS BIBLIOGRÁFICAS

Larsen P, Elsoe R, Hansen SP, Graven-Nielsen T, Laessoe U, Rassmusen S. Incidence and epidemiology of tibial shaft fractures. Injury [Internet]. 2015[citado 1 de abril de 2015];46(4):746750. Disponible en:

https://ncbi.nlm.nih.gov/m/pubmed/25636535

Wenger R, Oehme F, Winkler J, Perren SM, Babst R, Beeres FJP. Absolute or relative stability in minimal invasive plate osteosynthesis of simple distal meta or diaphyseal tibia fractures? Injury, Int J Care Injured [Internet]. 2017[citado 12 Feb 2020]; 48: 12171223. Disponible en:

https://www.researchgate.net/profile/Frank_Beeres/publication/314272568_Absolute_or_relative_stability_in_minimal_invasive_plate_osteosynthesis_of_simple_distal_meta_or_diaphyseal_tibia_fractures/links/5a6f3c1d4585154d138480d4/Absolute-or-relative-stability-in-minimal-invasive-plate-osteosynthesis-of-simple-distal-meta-or-diaphyseal-tibia-fractures.pdf

Wajnsztejna A, Santos Piresb RE, Godoy dos Santos AL, Labronicid PJ, Alvachian Fernandese HJ, Ferrettia M. Minimally invasive posteromedial percutaneous plate osteosynthesis for diaphyseal tibial fractures: technique description. Injury, Int. J. Care Injured [Internet]. 2017[citado 12 Feb 2020]; 48(4): 69. Disponible en:

https://ncbi.nlm.nih.gov/m/pubmed/29145970

Pai V, Coulter G, Pai V. Minimally invasive plate fixation of tibia. Int Orthop [Internet]. 2007[citado 12 Feb 2020]; 31: 491-6. Disponible en:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2267644/

Villamil Gallego CE, González Vargas JA, Velasco Barrera A, Martínez M, Fuentes R. Fracturas de extremo distal de tibia tratadas con placas de estabilidad angular. Estudio retrospectivo observacional entre técnica abierta y mínimamente invasiva. Rev Pie Tobillo [Internet]. 2015[citado 12 Feb 2020];29(1):11-16. Disponible en:

https://creativecommons.org/licenses/by-nc-nd/4.0/

Choi S, Lee TJ, Kim S, Cho C, Shim S, Kang H. Minimally Invasive Plate Osteosynthesis (MIPO) technique for complex tibial shaft fracture. Acta Orthop Belg [Internet]. 2019[citado 12 Feb 2020];85: 224-233. Disponible en:http://www.actaorthopaedica.be/assets/2777/11-Choi.pdf

Wang B, Zhao Y, Wang Q, Hu B, Sun L, Ren C, et al. Minimally invasive percutaneous plate osteosynthesis versus intramedullary nail fixation for distal tibial fractures: a systematic review and meta-analysis. J Orthopaedic Surg Res [Internet]. 2019[citado 12 Feb 2020]; 14: 456. Disponible en:

https://josr-online.biomedcentral.com/articles/10.1186/s13018-019-1479-0

Gülabi D, Bekler HL, Sağlam F, Taşdemir Z, Çeçen GS, Elmalı N. Surgical treatment of distal tibia fractures: open versus MIPO. Ulus Travma Acil Cerrahi Derg [Internet]. 2016[citado 12 Feb 2020];22(1):5257. Disponible en:

http://www.journalagent.com/z4/download_fulltext.asp?pdir=travma&plng=tur&un=UTD-82026

Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle International [Internet]. 1994[citado 12 Feb 2020]; 15(7): 349353. Disponible en:

https://journals.sagepub.com/doi/abs/10.1177/107110079401500701

Neinaa HA, Hannout YS, Abdel Wahab AAM. Evaluation of treatment of distal tibial fractures using the minimally invasive percutaneous plate osteosynthesis technique. Menoufia Medical J [Internet]. 2016[citado 12 Feb 2020];29: 691697. Disponible en:

http://www.mmj.eg.net/article.asp?issn=1110-2098;year=2016;volume=29;issue=3;spage=691;epage=697;aulast=Neinaa

Mann HS, Sahni G, Singal S, Singh H. Minimally invasive percutaneous plate osteosynthesis in treatment of diaphyseal tibial fractures without the use of image intensifier a study of 30 cases. Indian J Orthopaedics Surg [Internet]. 2019[citado 12 Feb 2020]; 5(1): 66-71. Disponible en:

https://www.researchgate.net/profile/Girish_Sahni2/publication/332424811_Minimally_invasive_percutaneous_plate_osteosynthesis_in_treatment_of_diaphyseal_tibial_fractures_without_the_use_of_image_intensifier_-_a_study_of_30_cases/links/5d70c2db92851cacdb21aa54/Minimally-invasive-percutaneous-plate-osteosynthesis-in-treatment-of-diaphyseal-tibial-fractures-without-the-use-of-image-intensifier-a-study-of-30-cases.pdf

Walia JPS, Gupta AC, Malu NG, Walia SK, Sethi S, Singh S. Minimally invasive plate osteosynthesis for the treatment of proximal tibial fractures. Pb J Orthopaedics [Internet]. 2013[citado 12 Feb 2020];1:32-35. Disponible en:

https://pdfs.semanticscholar.org/e9ee/7bdea5e73453c7ed6b7e0dfdda1eaba87c28.pdf

Akra GA, Lazarides S, Nanu AM. Early Results of Minimally Invasive Percutaneous Plate Osteosynthesis for Fractures of the distal tibia: A Retrospective Case Series and Review of the Literature. SAGE [Internet]. 2017[citado 12 Feb 2020]; 10: 1-7. Disponible en:

https://journals.sagepub.com/doi/pdf/10.1177/1179544117701724

Illur V, Shivgonda Patil R, Shah J, Chaudhary N, Bhosale V. Functional outcome of distal tibia fracture treated with locking compression plate using minimally invasive percutaneous plate osteosynthesis technique (MIPPO): A prospective study. International J Orthopaedics Sciences [Internet]. 2019[citado 12 Feb 2020]; 5(4):980-984. Disponible en:

http://www.orthopaper.com/archives/2019/vol5issue4/PartQ/5-4-148-772.pdf

Guo JJ, Tang N, Yang HL, Tang TS. A prospective, randomized trial comparing closed intramedullary nailing with percutaneous plating in treatment of distal metaphyseal fractures of tibia. J Bone Joint Surg [Internet]. 2010[citado 12 Feb 2020]; 92-B:984-988.

Disponible en:

https://pdfs.semanticscholar.org/f47c/253352a50aec798a5ea315c51f7cad72c8f6.pdf

Collinge C, Protzman R. Outcomes of Minimally invasive plate osteosynthesis for metaphyseal distal tibia fractures. J Orthop Trauma [Internet]. 2010[citado 12 Feb 2020];24(1): 24-29. Disponible en:

https://journals.lww.com/jorthotrauma/fulltext/2010/01000/outcomes_of_minimally_invasive_plate.6.aspx

Donimath VS, Chandan AE, Sandeep SR, Battur M. A prospective study on functional outcome of distal tibia fractures treated with minimally invasive percutaneous plate osteosynthesis. International J Orthopaedics Sciences [Internet]. 2018[citado 12 Feb 2020];4(1):585-589. Disponible en:

http://www.orthopaper.com/archives/2018/vol4issue1/PartI/4-1-4-432.pdf

Singh M, Singh Ghai I, Singh P, Singh S, Singh M, Dev P. A prospective study to evaluate the results of minimally invasive percutaneous plate osteosynthesis (MIPPO) in treatment of distal tibial fractures. JMSCR [Internet]. 2019[citado 12 Feb 2020]; 7(4):84-90. Disponible en:

https://dx.doi.org/10.18535/jmscr/v7i4.17

Published

2021-04-29

How to Cite

1.
Fenandez Lopez LA, García Martínez O, Martín león R, García Martínez O. Percutaneous Minimally Invasive Plate Osteosynthesis in Distal Tibial Fracture. Revista Cubana de Ortopedia y Traumatologí­a [Internet]. 2021 Apr. 29 [cited 2025 Mar. 9];35(1). Available from: https://revortopedia.sld.cu/index.php/revortopedia/article/view/353

Issue

Section

Presentación de casos