Alexandre A Sitnik1, Alexander V Beletsky. 1. Belarus Republic Scientific and Practical Center for Traumatology and Orthopedics, Kizhevatova 60-4, 220004, Minsk, Belarus. alexandre_sitnik@yahoo.com
Abstract
BACKGROUND: Minimally invasive percutaneous plate fixation (MIPPF) has gained wide acceptance for treating periarticular fractures of the tibia. Despite the theoretical biological advantages of MIPPF, it is unclear whether these are offset by wound complications, union rate, and malalignment. QUESTIONS/PURPOSES: We therefore estimated the rate of union in tibial fractures treated by MIPPF, the rate of major and minor wound complications, occurrence of malunion, and level of function. METHODS: We retrospectively reviewed 80 patients with tibia fractures treated by MIPPF. Mean age of patients was 43 years (range, 18-74 years); there were 54 male and 26 female patients. Severe soft tissue injuries were seen in 16 patients. Patients were examined clinically for soft tissue condition, ROM, alignment, and determination of function (Lower Extremity Functional Score). Radiographs and CT were obtained to determine union and malunion. The minimum followup was 12 months (mean, 23 months; range, 12-48 months). RESULTS: Sixty-three patients (79%) had uneventful healing of the fractures. We identified minor wound complications in seven patients (9%). Delayed union occurred in three (4%) and nonunion in seven (9%); noticeable axial malalignment occurred in five (6%), whereas rotational deformities greater than 10° were revealed with the use of CT in 25% of cases. CONCLUSIONS: MIPPF allowed uneventful healing and restoration of the preinjury level of function in most patients. However, complications occurred in a substantial number of patients, which needs attention when planning surgery.
BACKGROUND: Minimally invasive percutaneous plate fixation (MIPPF) has gained wide acceptance for treating periarticular fractures of the tibia. Despite the theoretical biological advantages of MIPPF, it is unclear whether these are offset by wound complications, union rate, and malalignment. QUESTIONS/PURPOSES: We therefore estimated the rate of union in tibial fractures treated by MIPPF, the rate of major and minor wound complications, occurrence of malunion, and level of function. METHODS: We retrospectively reviewed 80 patients with tibia fractures treated by MIPPF. Mean age of patients was 43 years (range, 18-74 years); there were 54 male and 26 female patients. Severe soft tissue injuries were seen in 16 patients. Patients were examined clinically for soft tissue condition, ROM, alignment, and determination of function (Lower Extremity Functional Score). Radiographs and CT were obtained to determine union and malunion. The minimum followup was 12 months (mean, 23 months; range, 12-48 months). RESULTS: Sixty-three patients (79%) had uneventful healing of the fractures. We identified minor wound complications in seven patients (9%). Delayed union occurred in three (4%) and nonunion in seven (9%); noticeable axial malalignment occurred in five (6%), whereas rotational deformities greater than 10° were revealed with the use of CT in 25% of cases. CONCLUSIONS: MIPPF allowed uneventful healing and restoration of the preinjury level of function in most patients. However, complications occurred in a substantial number of patients, which needs attention when planning surgery.