Literature DB >> 19169106

Minimally invasive plating of the distal tibia: do we really sacrifice saphenous vein and nerve? A cadaver study.

Mehmet Hakan Ozsoy1, Eray Tuccar, Deniz Demiryurek, Alp Bayramoglu, Mutlu Hayran, Ali Turgay Cavusoglu, Veysel Ercan Dincel, Abdurrahman Sakaogullari.   

Abstract

OBJECTIVE: To investigate the risk of saphenous nerve (SN) and great saphenous vein (GSV) injury during percutaneous screw placement of the 3.5/4.5 LCP Distal Tibial Metaphyseal Plate and the 3.5-mm LCP Medial Distal Tibia Plate with tab in distal tibias of cadaver extremities.
METHODS: Thirty-one unpaired (1 fresh and 30 formalin fixed) adult cadaveric lower extremity specimens were dissected. Using the principles of minimally invasive plating, a 3.5/4.5 LCP Distal Tibial Metaphyseal Plate was implanted in 16 extremities and a 3.5-mm LCP Medial Distal Tibia Plate with tab in the remaining 15 extremities. Injuries to or any evidences of direct contact with the SN or GSV were recorded. Additionally, the shortest distances of each hole to the main branches of these anatomic structures were measured.
RESULTS: The risk of injury to the SN and GSV was higher in holes 4, 5, and 6 when using the 3.5/4.5 LCP Distal Tibial Metaphyseal Plate and in holes 3, 5, and 8 when using the 3.5-mm LCP Medial Distal Tibia Plate.
CONCLUSIONS: The SN and GSV are at high risk for injury during percutaneous screw placement of the 3.5/4.5 LCP Distal Tibial Metaphyseal Plate and the 3.5-mm LCP Medial Distal Tibia Plate at the distal tibia. Careful dissection in the stab incisions down the plate, atraumatic placement of the drill sleeves, and protection of the soft tissues during screw insertion might decrease the risk of injury to the SN and GSV.

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Year:  2009        PMID: 19169106     DOI: 10.1097/BOT.0b013e3181969993

Source DB:  PubMed          Journal:  J Orthop Trauma        ISSN: 0890-5339            Impact factor:   2.512


  8 in total

1.  The relationship of neural structures to arthroscopic posterior portals according to knee positioning.

Authors:  Jin Hwan Ahn; Sang Hak Lee; Ho Joong Jung; Kyung Hyo Koo; Seong Hwan Kim
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2010-12-11       Impact factor: 4.342

2.  Minimally invasive percutaneous plate osteosynthesis for closed distal tibial fractures: a consecutive study based on 25 patients.

Authors:  Rafiq Bhat; Mubashir Maqbool Wani; Shakir Rashid; Nahida Akhter
Journal:  Eur J Orthop Surg Traumatol       Date:  2014-09-20

3.  Comparison study of two surgical options for distal tibia fracture-minimally invasive plate osteosynthesis vs. open reduction and internal fixation.

Authors:  Wang Cheng; Ying Li; Wang Manyi
Journal:  Int Orthop       Date:  2010-06-02       Impact factor: 3.075

4.  Distal tibia fractures: management and complications of 101 cases.

Authors:  Pierre Joveniaux; Xavier Ohl; Alain Harisboure; Aboubekr Berrichi; Ludovic Labatut; Patrick Simon; Didier Mainard; Nicolas Vix; Emile Dehoux
Journal:  Int Orthop       Date:  2009-06-25       Impact factor: 3.075

5.  Single‑incision technique for the internal fixation of distal fractures of the tibia and fibula: a combined anatomic and clinical study.

Authors:  Baoqing Yu; Gan Huang; Josiah T George; Wenrui Li; Sihua Pan; Haiyan Zhou
Journal:  Arch Orthop Trauma Surg       Date:  2013-12       Impact factor: 3.067

6.  A gross anatomic study of distal tibia and fibula for single-incision approach.

Authors:  Hui Ma; Jie Zhao; Baoqing Yu; Bin Ye
Journal:  J Orthop Surg Res       Date:  2014-04-24       Impact factor: 2.359

7.  Plate on plate technique of minimally invasive percutaneous plate osteosynthesis in distal tibial fractures, an easy and inexpensive method of fracture fixation.

Authors:  Nasir Muzaffar; Rafiq Bhat; Mohammad Yasin
Journal:  Arch Trauma Res       Date:  2014-09-02

8.  Complications of Minimally Invasive Percutaneous Plating for Distal Tibial Fractures.

Authors:  Nasir Muzaffar; Rafiq Bhat; Mohammad Yasin
Journal:  Trauma Mon       Date:  2016-03-20
  8 in total

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