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Objective To evaluate the preliminary clinical effect of anterior anatomical reduction plate fixation on the treatment of atlantoaxial dislocation. Methods A retrospective case series study was conducted to analyze the 13 patients with atlantoaxial dislocation admitted to the second affiliated hospital of Xi'an Jiaotong University from January 2016 to December 2017. There were eight males and five females, aged 20-57 years, with an average age of 42 years. All patients received transoropharyngeal reconstruction and atlantoaxial anterior anatomical reduction plate fixation, 12 of which underwent the surgery for the first time but one had the revision surgery. The operation time and intraoperative bleeding were recorded. The angle of the clivus axis was measured, and the reduction of the atlantoaxial spine and the fusion of bone graft were observed. The neurological function was evaluated by Japanese Orthopedic Association ( JOA ) score and the improvement rate of spinal cord function was calculated. The complications were also recorded. Results All patients were followed up for 10-30 months [(14. 2 ± 5. 0)months]. The operation time was 150-285 minutes [(216. 8 ± 36. 7)minutes]. The intraoperative blood loss was 50-130 ml [(80. 5 ± 19. 7)ml]. The slope axis angle was (113. 2 ± 9. 1)° before operation and (145. 8 ± 6. 7)° after operation, with an average increase of 32. 6° (P<0. 01). Anatomical reduction was obtained in nine patients, and partial reduction in four patients. At the last follow-up, the atlantoaxial fusion was obtained in all patients, and the healing time was ( 4. 6 ± 1. 1 ) months. Postoperative neurological symptoms were improved compared with those before operation. The JOA score was improved from preoperative (8. 7 ± 1. 7) points to postoperative (14. 3 ± 1. 2) points, with an average increase of 5. 6 points (P<0. 01). The average improvement rate of spinal cord function was 69％. Except for one patient with cerebrospinal fluid leakage, there were no complications such as spinal cord, nerve, blood vessel injury or wound infection after operation. Conclusions Anterior atlantoaxial anatomical reduction plate fixation can effectively restore the dislocated atlantoaxial joint, restore slope axis angle, improve bone fusion rate, and improve nerve function. It can be used as an alternative or supplement to posterior fixation.
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Introducción Las fracturas de húmero diafisarias corresponden al 3-5% de las fracturas en general. La distribución de las fracturas que comprometen el tercio distal de la diáfisis es variable con incidencias estimadas entre el 10 y el 48%. El objetivo del estudio es evaluar los resultados funcionales y la tasa de consolidación de un grupo de pacientes con fractura diafisaria de húmero del tercio distal con técnica mínimamente invasiva por vía posterior. Materiales y métodos Entre 2013 y 2016 se intervino a 23 pacientes, con una media de edad de 36 años. La valoración funcional se realizó por medio de la Escala de Discapacidades del Hombro, el Codo y la Mano (DASH) abreviada y la medición de los arcos de movilidad de hombro y codo con goniometría; el dolor fue evaluado de acuerdo con la Escala Visual Análoga del Dolor (EVA). Resultados Todas las fracturas consolidaron de forma exitosa, excepto dos casos que presentaron retardo en la consolidación. La lesión del nervio radial previa a la intervención se recuperó de forma progresiva sin requerimiento de transferencias. Los resultados funcionales fueron satisfactorios en un grupo de diez pacientes que completaron más de 1 año de seguimiento. Discusión El abordaje posterior de humero con mínima invasión en el tratamiento de este patrón particular de fracturas parece que muestra una ventaja biológica al permitir una consolidación completa en todos los pacientes. La lesión del nervio radial iatrogénica no parece que aumente en relación con su aislamiento y protección en la porción proximal del tríceps. Nivel de evidencia clínica Nivel IV.
Background Diaphyseal humeral fractures correspond to 3-5% of all fractures. The proportion of these fractures in which the distal third of the diaphysis is involved is variable with estimated incidences between 10-48%. The aim of the study is to evaluate the functional results and rate of fracture consolidation for a group of patients with distal third diaphyseal humeral fractures managed using a minimally invasive technique through a posterior approach. Materials and methods Twenty-two patients (mean age of 36 years) were evaluated between 2013 and 2016. Functional assessment was performed using the DASH abbreviated functional scale. Shoulder and elbow mobility range of motion were measured with goniometry, and pain was measured following the VAS scale. Results All fractures consolidated successfully, with two cases exhibiting delay in consolidation. Radial nerve injury prior to the intervention was progressively recovered without the need for supplementary tendons transfers. Functional results were satisfactory for ten patients that completed more than one year of follow-up. Discussion Minimally invasive technique with posterior approach in the treatment of this particular pattern of humeral fractures seems to show a biological advantage in allowing complete consolidation in all patients. Iatrogenic radial nerve injury does not appear to increase in relation to its isolation and protection in the proximal portion of the triceps. Evidence level IV.
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Humans , Humeral Fractures , Minimally Invasive Surgical Procedures , AnatomyABSTRACT
Objective: To develop an anatomical locking plate in accordance with the anatomical characteristics of the sternoclavicular joint, which is reliable fixation and easy to operate, so as to provide an ideal internal fixation device for the treatment of sternoclavicular joint dislocation or peripheral fractures.
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Objective To investigate the effect of locking compression plate(LCP)and anatomi-cal plate(AP)in the treatment of closed tibial Pilon fracture and its influence on lower limb functional re-habilitation.Methods A total of 82 patients with closed tibial Pilon fractures were randomly divided into LCP internal fixation group(LCP group,n=41)and AP internal fixation group(AP group,n=41).The perioperative indexes and the incidence of postoperative complications were compared between the two groups.The ankle function was evaluated by American Orthopaedic Foot & Ankle Society Ankle Hindfoot Scale(AOFAS-AHS),the lower limb function was evaluated by Lysholm scale,the serum levels of inter-leukin-1β(IL-1β)and interleukin-6(IL-6)were detected.Results The intraoperative blood loss,opera-tion time,hospitalization time,first ground time,fracture healing time were(103. 34 ± 11. 34)ml, (47.65 ± 7.89)min,(9.01 ± 2.23)d,(5.31 ± 1.27)d,(16.23 ± 2.12)weeks in LCP group respective-ly,the AP group were(132.25 ± 34.41)ml,(60.54 ± 11.23)ml,(11.43 ± 2.57)d,(6.23 ± 1.56)d, (23.12 ± 3.31)weeks,respectively.The LCP group were significantly lower than AP group(P<0.05);The excellent rate of ankle function of LCP group was 95.12%,significantly higher than 82.93% in the AP group(P<0.05);The incidence of postoperative complications was 4.88% in the LCP group,which was significantly lower than 29.27% in the AP group(P<0.05);At 3,6 and 12 months after operation, the AOFAS-AHS scores in the LCP group were(69.52 ± 4.18)points,(78.89 ± 6.73)points and (87.23 ± 6.34)points respectively,the AP group were(65.09 ± 4.45)points,(70.13 ± 5.34)points and (76.69 ± 5.91)points respectively,the LCP group were significantly higher than AP group(P<0.05);At 3,6 and 12 months after operation,the Lysholm scores were(77.12 ± 6.43)points,(82.12 ± 7.81)points and(86.19 ± 8.11)points in LCP group,AP group were(67.25 ± 5.56)points,(72.21 ± 7.23)and (77.12 ± 7.54)points,the LCP group was significantly higher than AP group(P<0.05).At 3 d and 4 weeks after operation,the serum levels of IL-1β in LCP group were(0.37 ± 0.09)pg/ml,(0.19 ± 0.06) pg/ml,while in AP group were(0.45 ± 0.13)pg/ml,(0.27 ± 0.09)pg/ml;the serum levels of IL-6 in LCP group were(201.23 ± 30.12)ng/L,(102.23 ± 25.21)ng/L,while in AP group were(246.71 ± 41.23)ng/L,(158.95 ± 25.21)ng/L.The AP group were significantly lower than those in AP group(P<0.05).Conclusion LCP and AP in treatment of closed tibial Pilon fractures have a significant effect,but LCP can reduce the surgical trauma,shorten the operation time and postoperative recovery time,to a cer-tain extent,improve the ankle and lower limb function,and reduce the postoperative fixation fracture heal-ing and other complications.
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BACKGROUND: Increased frequency of comminuted clavicle mid-shaft fractures and importance of functional satisfaction through early joint exercise has resulted in higher emphasis on surgical treatments. This study aimed to evaluate the clinical radiological results of treatment of clavicle mid-shaft fractures by open reduction and internal fixation using a plate with a small incision. METHODS: The subjects of this study were 80 clavicle mid-shaft fracture cases treated with internal fixation using a plate from October 2010 to July 2014. Clavicle mid-shaft fractures were internally fixated using anatomical plates or locking compression plates. Achievement of bone union, union period, and clavicle length shortening were evaluated radiologically, and clinical assessment was done by using Constant and University of California at Los Angeles (UCLA) scores. RESULTS: All 80 cases were confirmed to have achieved bone union through radiographs with an average union period of 10.9 weeks (range: 7–18 weeks). The average clavicle length of shortening in the affected side was 1.8 mm (range: 0–17 mm). The average UCLA score and Constant score were 33.6 (range: 25–35) and 92.5 (range: 65–100), respectively. Regarding complications, four cases reported skin irritation by metal plates, and one case reported a screw insertion site fracture due to minor trauma history. CONCLUSIONS: We were able to induce successful bone union and obtain clinically satisfactory results in displaced mid-shaft fractures of the clavicle without major complications such as nonunion through treatment of internal fixation using a plate.
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California , Clavicle , Joints , SkinABSTRACT
BACKGROUND: Increased frequency of comminuted clavicle mid-shaft fractures and importance of functional satisfaction through early joint exercise has resulted in higher emphasis on surgical treatments. This study aimed to evaluate the clinical radiological results of treatment of clavicle mid-shaft fractures by open reduction and internal fixation using a plate with a small incision. METHODS: The subjects of this study were 80 clavicle mid-shaft fracture cases treated with internal fixation using a plate from October 2010 to July 2014. Clavicle mid-shaft fractures were internally fixated using anatomical plates or locking compression plates. Achievement of bone union, union period, and clavicle length shortening were evaluated radiologically, and clinical assessment was done by using Constant and University of California at Los Angeles (UCLA) scores. RESULTS: All 80 cases were confirmed to have achieved bone union through radiographs with an average union period of 10.9 weeks (range: 7–18 weeks). The average clavicle length of shortening in the affected side was 1.8 mm (range: 0–17 mm). The average UCLA score and Constant score were 33.6 (range: 25–35) and 92.5 (range: 65–100), respectively. Regarding complications, four cases reported skin irritation by metal plates, and one case reported a screw insertion site fracture due to minor trauma history. CONCLUSIONS: We were able to induce successful bone union and obtain clinically satisfactory results in displaced mid-shaft fractures of the clavicle without major complications such as nonunion through treatment of internal fixation using a plate.
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California , Clavicle , Joints , SkinABSTRACT
Objective To compare the effect of anatomical plate and dynamic hip screw(DHS) for elderly patients with intertrochanteric fracture.Methods The clinical data of medical treatments for elderly patients with intertrochanteric fracture were retrospectively analyzed.36 cases received anatomical plate treatment were selected as observation group,and 34 cases received DHS were selected as control group.Results The operation time,intraoperative blood loss,postoperative length of stay(LOS) and the time of fracture healing in observation group were obviously shorter than those in control group(t =2.18,2.35,2.31,2.15,all P ＜0.05).In observation group,3 cases appeared postoperative complications,included 2 cases of pulmonary infection,and 1 case of varus deformity of hip joint.In control group,9 cases appeared postoperative complications,included 2 cases of pulmonary infection,4 cases of varus deformity of hip joint,2 cases of limb shortening deformity,and 1 case of deep venous thrombosis of lower extremity.The incidence rate of complication of the observation group was 8.33％,which was significantly lower than 26.47％ of the control group (x2 =4.05,P ＜ 0.05).The patients were followed up for 12 to 21 months after operation,average (16.7 ±4.2)months,the excellent and good rate of the function of postoperative hip joint in the observation group was 86.11％,which was significantly higher than 64.71％ in the control group (x2 =4.36,P ＜ 0.05).Conclusion Both anatomical plate and DHS have favorable effect on old patients with intertrochanteric fracture,and anatomical plate has advantages such as short operation time,a small amount of intraoperative bleeding,short postoperative LOS,short time of fracture healing,less postoperative complication,high excellent and good rate of the function of postoperative hip joint and etc,and it is preferably suitable for the comminuted fracture which cannot be cured by DHS.
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BACKGROUND: Distal radius fracture is the most common fracture of the upper extremity, and approximately 60,000 distal radius fractures occur annually in Korea. Internal fixation with an anatomical volar locking plate is widely used in the treatment of unstable distal radius fractures. However, most of the currently used distal radius anatomical plate systems were designed based on the anatomical characteristics of Western populations. Recently, the Korean-type distal radius anatomical volar plate (K-DRAVP) system was designed and developed based on the anatomical characteristics of the distal radius of Koreans. The purpose of this study was to evaluate the preliminary results of the new K-DRAVP system, and to compare its radiologic and functional results with those of the other systems. METHODS: From March 2012 to October 2012, 46 patients with acute distal radius fractures who were treated with the K-DRAVP system at three hospitals were enrolled in this study. Standard posteroanterior and lateral radiographs were obtained to assess fracture healing, and three radiographic parameters (volar tilt, radial inclination, and radial length) were assessed to evaluate radiographic outcomes. The range of motion and grip strength, the Gartland and Werley scoring system, and the disabilities of the arm, shoulder and hand (DASH) questionnaire were used to assess clinical and functional outcomes. RESULTS: All radiologic parameters were restored to normal values, and maintained without any loosening or collapse until the time of final follow-up. Grip strength was restored to 84% of the value for the unaffected side. The mean range of motion of the wrist at final follow-up was restored to 77%-95% of the value for the unaffected side. According to the Gartland and Werley scoring system, there were 16 excellent, 26 good, and 4 fair results. The mean DASH score was 8.4 points. There were no complications after surgery. CONCLUSIONS: The newly developed K-DRAVP system could be used to restore and maintain good anatomical parameters, and provide good clinical outcomes with low complication rates. This system is a promising surgical option for the treatment of distal radius fractures in the Korean population.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Bone Plates , Fracture Fixation, Internal/instrumentation , Radius/diagnostic imaging , Radius Fractures/diagnostic imaging , Range of Motion, Articular , Republic of Korea , Palmar PlateABSTRACT
Objective To compare the curative effect of anatomical plate and locking plate in treatment of calcaneous intraarticular fracture. Methods 67 petiants with calcaneous intraarticular fracture were randomly divided into anatomical plate group (n=33) and locking plate group (n=34) . The Bo..hler angle, the Gissane angle, the length of calcaneal axis, the width and height of calcaneous and the Maryland grade were compared at 1 week and 6 month after operation. Results (1) week after operation, the Bo..hler angle, the Gissane angle, the height and width of calcaneous, the length of calcaneal axis, the Maryland grade had no significant difference between 2 groups . 6 months after operation, the Bo..hler angle, the Gissane angle, the height of calcaneous had significant differe nce between 2 groups. There was no significant difference in the length of calcaneal axis and the grade of Maryland between 2 groups. Conclusions The locking plate group is better than anatomical plate group in major anatomical measure indicators in 6 months follow up. The therapy of locking plate is worth of clinical promotion.
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Objective To investigate the effects of treatment of proximal humeral fracture in the elderly with anatomical plate internal fixation.Methods Twenty-seven cases of proximal humeral fractures received operative treatment with anatomical plate.According to Neer classification,there were 18 patients with three-part fractures of the bone,there were 9 patients with four-part fractures of the bone.Results Twenty-seven patients were followed up for 6-24 months.According to the evaluation of Herscovici scales,the result were excellent in 17 cases,and good in 8,92.6％ (25/27) of all reductions were excellent or good.The excellent and good rate of Constant-Murley score was 88.9％(24/27 ).Conclusion It is an ideal way to treat the displaced proximal humeral fracture with anatomical plate,which can provide rigid fixation,it allows early functional treating.
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PURPOSE: To evaluate clinical and radiological results of surgical treatment of distal femur medial condyle fracture using lateral anatomical plate of opposite side through medial approach. MATERIALS AND METHODS: This study reviewed the results of 9 cases of distal femur medial condyle fracture treated with lateral anatomical plate of opposite side through medial approach from December 2005 to June 2007, after a follow up of more than 12 months. There were 2 males and 7 females with a mean age of 63.1 (57~72) years. The clinical results were evaluated using the Schatzker's criteria, and the radiographic results were evaluated using the bone union time. RESULTS: Using the Schatzker's criteria, 7 cases of the 9 patients (78%) showed exellent results. The mean time for bone union was 13.4 (11~15) weeks. There were 3 cases of pain on full weight bearing same as previous operative state by degenerative osteoarthritis. There weren't complications as joint stiffness, infection, varus & rotational deformity, malunion, nonunion, and metal failure. CONCLUSION: Plate fixation using medial approach provides the proper anatomical reduction and stronger fixation, and outcome good results.
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Female , Humans , Male , Congenital Abnormalities , Femur , Follow-Up Studies , Joints , Osteoarthritis , Weight-BearingABSTRACT
[Objective]To investigate the treatment effects of the anatomical plate on proximal humeral fractures and analyze the structural characteristics of the plate clinically.[Method]From June 2003 to June 2005,comminuted fractures of the proximal humerus of 32 patients(18 males and 14 females,with average age of 39 years)were treated with anatomical plates.Fractured proximal humerus was exposed by a standard deltopectoral approach after a dissection from the deltoid and pectoral muscle.Anatomical plates were placed on lateral sides of the humerus after reduction.The arm was immobilized in a sling,passive movement was begun on the first day after surgery,and active movement of the shoulder was started after three week.Active movement with resistance was allowed when there was radiological evidence of bone healing which usually occurred after six weeks.The patients were reviewed clinically and radiologically.[Result]All 32 patients were available at follow up with mean duration of 20 months (7~28 months).No complications such as nonunion of fractures,infection,the loosening and breakage of the plate were ever occurred.The clinical results were graded as excellent in 21 patients,good in 7,fair in 2,and poor in 2 according to the Neer's classification.The excellent and good rate was 87.5%.[Conclusion]Anatomical plate for the proximal humerus holds a 3-dimensional structure,which facilitates the fracture exposure,bone fragments reduction and fixation.It is concluded that rigid fixation of displaced fractures of the proximal humerus with an anatomical plate provides sufficient primary stability to allow early functional treatment.And is advocated that primary open reduction and rigid internal fixation using anatomical plates for the proximal humerus fracture.
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[Objective]To investigate the treatment of fractuees of distal end of humerus with open reduction and internal fixation with anatomical plate.[Method]From February 2001 to April 2006,open reduction and anatomical plate internal fixation were performed in 22 cases with distal end of humerus fracture,of which olecranon osteotomy approach was carried out in 11 while musculus triceps brachii linguiform flap approach in other 11.All the patients received combined therapy including fumigation and rinsing with Chinese herbs,CPM(continuous passive motion) and manipulation.[Result]All the cases were followed up for 13 to 22 months.All the fractures got union.The postoperative elbow functions were excellent in 9 cases,good in 7 cases according to Mayo standards.The satisfactory rate was 72.71%.[Conclusion]Open reduction and internal fixation with anatomical plate can provide stable fixation and allow early postoperative elbow functional training in treatment of distal humerua fracture.Good clinical results can be achieved using fumigation and rinsing with Chinese herbs,CPM and manipulation after operation.
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Objective To explore efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of distal tibia comminuted fracture by using normal anatomical plate. Methods Between January 2007 and July 2008,18 cases of distal tibia facture were treated by MIPPO using anatomical plate. The clinical data of the patients were reviewed. Results A mean of 6.5 cm incision (5.0-8.5 cm) was made in the patients; the intraoperative blood loss ranged from 60 to 300 ml (mean,145 ml);and the operation time ranged from 30 to 120 min with a mean of 63 min. After the surgery,2 patients developed mild skin necrosis,and was then cured by conventional therapy; no patient had nonunion of the fracture,failure of internal fixation,or delayed wound healing. The 18 cases were followed up for a mean of 8 months (range,4 to 10 months); all of them were healed clinically and could walk without crutch in 4 months postoperatively. According to Johner-Wruhs score system,11 were excellent and 7 were good; the excellent-good rate was 100%. Conclusions MIPPO with anatomical plate is an optimal treatment for distal tibia comminuted fracture with advantages in protecting the soft issues and bony blood supply,promoting the wound-healing process,and reducing the rate of complications.
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Objective To report the clinical features and effects of internal fixation with anatomical plate in combination with bone graft in treatment of complicated comminuted fractures of distal femur. Methods There were 11 case of type C2 and 9 cases of type C3 fractures of distal femur according to the AO classification. When they were treated with anatomical plate, bone grafting from ilium or fibula or from both was done to repair their bone defects depending on specific defects of the patients. Results All the patients were followed up for a mean of 20 months (ranging from 10 to 24 months). Bone healed in all the cases. By Schatzker standards, the result was excellent in 14 patients, good in 5 and fair in 1. The excellent and good rate was 95%. Conclusion The authors consider that anatomical plate in combination with bone graft is an ideal treatment for complicated comminuted fractures of distal femur.
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PURPOSE: The purpose of this study is to evaluate the effectiveness of anterolateral approach of the ankle for the distal tibial fracture in aspect of preventing complication and acquiring union. MATERIALS AND METHODS: Authors reviewed 21 patients of distal metaphyseal fracture of the tibia treated by anterolateral approach and lateral plating method from February, 2000 to May, 2002. Mean follow-up period was 17 months (12~29 months). There were twelve type A, two type B, and four type C patients according to AO/OTA classification. We have analyzed the bone union rate and Ovadia`s functional scale. We also reviewed the complication rate, such as soft tissue problem and postoperative infection. RESULTS: In all cases union was achieved and mean time to union were 16 weeks. The functional result by Ovadia's scale were 17 excellent cases and 4 good cases in objective evaluation, and 19 excellent cases and 2 good cases in subjective evaluation. Wound infection occurred in one case, but the infection was controlled after plate removal and the union was acquired through cast immobilization. There was no other complication, such as soft tissue necrosis. CONCLUSION: The anterolateral approach is a safe and worthwhile method for distal tibia fracture while avoiding some of the complication associated with standard anteromedial approach and plating method.
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Humans , Ankle , Classification , Follow-Up Studies , Immobilization , Necrosis , Tibia , Tibial Fractures , Wound InfectionABSTRACT
Objective To investigate the treatment of complex fractures of distal femur with open reduction and internal fixation with anatomical plate. Methods From January 2001 to June 2004, 67 cases of complex fractures of distal femur were treated with open reduction and anatomical plate internal fixation. The allogeneic bone was grafted for 23 cases, ilium was grafted for 35 cases, ilium and fibula were grafted for 9 cases. Bio- resorbable membranes were used between quadriceps femoris and femur. 13 cases were aided with patella traction. All the patients received fumigation and rinsing with Chinese herbs and CPM(continuous passive motion) after operation. Results All the 67 cases were followed up for 10 to 26 months. All the fractures got united. The postoperative knee functions were excellent in 36 cases, good in 23 cases, fair in 5 cases, and poor in 3 cases according to Kolment standards. The excellent and good rate was 88.1% . Conclusions Open reduction, internal fixation with anatomical plate, bone grafting, local use of bio- resorbable membranes, patella traction when necessary, fumigation and rinsing with Chinese herbs and CPM after operation are good measures to treat complex fractures of the distal femur, because they can provide stable fixation, allow early postoperative functional training, and prevent adhesion of quadriceps femoris and stiffness of the knee joint
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Objective To investigate the clinical results of Link anatom ical distal femoral plate in treatment of distal femoral fractures. Methods 39 c ases of distal femoral fractures who were admitted after February 2001were treat ed with Link anatomical distal femoral plate. All the 39 cases were followed up for 7 to 26 months. Results All the fractures got united, without complications of no-union, screw loosening or plate breakage. The excellent rate of the knee function was 89.74%. Conclusion Link anatomical distal femoral plate, when used to treat distal femoral fractures, is simple to handle, gives reliable fixation , and facilitates rehabilitation of the knee.
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Objective To discuss our tentative application of the anatomic plate in the treatment of distal tibia fractures in order to develop a new effective fixation technique for this kind of fracture. Methods From November 2000 to September 2001, the authors applied Linkdistal tibia anatomical plates in the treatment of distal tibia fractures, which involved metaphysis in 12 cases, including 8 males and 4 females, aged from 18 years ～66 years, with 38 years on average. All the cases were of high energy injuries and complicated with ipsilateral fibular fracture. According to AO/ASIF classification: three were type A1, five were A2, three were A3, and one was B1; three of them were close fractures, five were type IO1 open fractures, and four were IO2. Results All the cases healed at one stage without infection or exposure of the implant. Bone callus could be found 2 3 weeks after operation. Bone union was achieved within 3～6 months, with 4 months on average. No delayed union or non union occurred. Functions of ankle joints recovered completely. Conclusion The anatomical plate for distal tibia is supperior to the traditional plates in both biomechanical and biological aspects. It is the best choice for the treatment of distal tibia fractures.