Role of Appositional Screw Fixation in Minimally Invasive Plate Osteosynthesis for Distal Tibial Fracture
| Autor: | Sungjun Kim, Dong-Hyun Kang, Kyu Hyun Yang, Jin Cheol Oh, Yougun Won |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Callus formation Bone Screws Nonunion Bone healing Ankle Fractures Fracture Fixation Internal Fixation (surgical) Fracture fixation Bone plate Humans Minimally Invasive Surgical Procedures Medicine Orthopedics and Sports Medicine Aged Aged 80 and over Fracture Healing business.industry Spiral fracture General Medicine Middle Aged musculoskeletal system medicine.disease Surgery Radiography Tibial Fractures Treatment Outcome medicine.anatomical_structure Female Ankle business Bone Plates |
| Zdroj: | Journal of Orthopaedic Trauma. 29:e331-e335 |
| ISSN: | 0890-5339 |
| DOI: | 10.1097/bot.0000000000000341 |
| Popis: | OBJECTIVES To determine the effect of interfragmentary appositional (gap-closing) screw fixation in minimally invasive plate osteosynthesis (MIPO) for distal tibial fractures on the clinical and radiologic results. DESIGN Prospective nonrandomized study. SETTING Level I trauma center. PATIENTS Sixty patients who were diagnosed as distal metadiaphyseal oblique or spiral tibial fracture without displaced articular fragment. INTERVENTION Thirty patients (group A) of the 60 patients were treated with MIPO without appositional screw fixation, and the other 30 (group B) were treated with the screw. MAIN OUTCOME MEASUREMENTS Radiologic union, clinical union, clinical functional score [American Orthopaedic Foot and Ankle Society (AOFAS) score], and complications. RESULTS The time for initial callus formation and radiologic union was significantly longer in group A than those in group B (76.8 vs. 58.0 days, P = 0.044; 409 vs. 258.7 days, P = 0.002, respectively). The rate of clinical union during 1 year was significantly higher in group B than in group A (P = 0.0063). Four nonunion patients in group A achieved bone union after placement of an additional bone graft. None of the patients in group B diagnosed with delayed union or nonunion (P < 0.001). None of the patients of both groups had malreduction, skin problems, or infection. Overall, the AOFAS score did not significantly differ between groups A and B (85.4 vs. 87.0, P = 0.43). CONCLUSIONS The use of additional interfragmentary appositional screw fixation in distal tibia MIPO for the fixation of oblique or spiral fracture promoted callus formation and union rate compared with MIPO without appositional screw fixation. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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