Comparison of Antiglide Plate Fixation and Lateral Plate Fixation for Danis-Weber Type B Isolated Lateral Malleolar Fractures / 대한족부족관절학회지

PURPOSE: This study was performed retrospectively and to compare the clinical outcomes of the surgical management using Antiglide plating and lateral plating for Danis-Weber type B isolated lateral malleolar fractures. MATERIALS AND METHODS: Between March 2004 and March 2009, 92 patients were followed up for more than 6 months after surgical treatment. 49 patients were treated with Antiglide plating, whereas the remaining 43 patients underwent lateral plating. The results of the two groups were analyzed both radiographically and clinically using Ankle scoring system. RESULTS: Both groups were comparable for age, sex distribution, time to surgery, and operation time. Bone union was noted at average of 8 weeks in all fractures. The mean ankle score was similar in both groups (94% versus 93%). CONCLUSION: Antiglide plating for Danis-Weber type B isolated lateral malleolar fracture is one of the good methods which has some advantages such as early ankle motion, ambulation and smaller operative incision.

Staged Protocol in Treatment of Open Distal Tibia Fracture: Using Lateral MIPO

BACKGROUND: To evaluate the radiological, clinical results in patients with open distal tibia factures, who were treated with a staged treatment protocol using the lateral minimally invasive plate osteosynthesis (MIPO) technique. METHODS: From January 2007 to June 2009, 10 patients with open distal tibia fractures (Gustilo-Anderson classification II, 3; IIIA, 1; IIIB, 6) were treated using a staged treatment protocol. The initial debridement and application of an external fixator were performed within 24 hours and the mean interval from injury to definitive surgical treatment was 15 days (range, 6 to 52 days). Eight weeks later, an additional bone graft was performed in 3 patients. The follow-up duration was more than 1 year. RESULTS: The mean fracture healing time was 21 weeks (range, 17 to 28 weeks), and the average Iowa ankle rating score was 84.5 points. At the last follow-up, there was no non-union, angular deformity > 5degrees, shortening > 10 mm or infection. In 10 patients, 2 patients had a superficial wound infection, and another 2 patients showed limitation of ankle joint motion. CONCLUSIONS: This staged treatment protocol using a lateral MIPO technique is a useful alternative method for achieving high functional recovery with good healing and low complication rates in patients with an open distal tibia fracture.

Minimally Invasive Percutaneous Plate Osteosynthesis Using a Lateral Plate in Distal Tibial Fracture

PURPOSE: To evaluate the efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) using a lateral plate (Zimmer, Periarticular Lateral Distal Tibial Plates, USA) in distal tibial fracture within 3 cm to plafond, associated with medial soft tissue damage. MATERIALS AND METHODS: From January 2005 to December 2007, 15 patients with distal tibial fracture treated by MIPPO technique using a lateral plate were analyzed. The duration of follow-up was more than 1 year. We evaluated union time by simple X-ray, clinical results by IOWA ankle rating system, and complication. RESULTS: The bone union was achieved in all cases at average 16.7 weeks. Evaluation of the ankle function test showed an average of 90.3 points, resulting in satisfactory. At the last follow-up, there was no non-union, angular deformity more than 5 degrees or infection. CONCLUSION: We concluded that MIPPO technique using a lateral plate is a efficient method for high functional recovery with good bone healing and low complication in distal tibial fracture within 3 cm to plafond, associated with medial soft tissue damage.

Lateral Plate Fixation of Distal Tibial Metaphyseal Fracture Using Minimally Invasive Plate Osteosynthesis Technique

PURPOSE: To evaluate the efficiency of lateral plate fixation using minimally invasive plate osteosynthesis (MIPO) technique as a treatment of distal tibial metaphyseal fracture. MATERIALS AND METHODS: Among the patient who were treated from March, 2002 to September, 2004, the cases of twenty patients with distal tibial metaphyseal fracture treated by lateral plate fixation using MIPO technique who were able to be followed up for at least one-year period were reviewed in this study. According to AO/OTA classification, five were type A1, twelve cases were type A2 and other three cases were type A3, and among them two cases were open fracture type I according to the Gustillo-Anderson classification. Radiologic studies and clinical assessment described by Daniel et al and complication following the treatment were evaluated. RESULTS: At a mean of 16.4 weeks (range 11 to 23), all fractures united without secondary procedures. According to clinical assessment, all cases had good and excellent result, and there were no complications. CONCLUSION: The lateral plate fixation using MIPO technique of distal tibial metaphyseal fracture is an efficient method of treatment with high functional recovery rate which minimize soft tissue damage, decreases the risk of infection and incidence of nonunion at the same time as the classic MIPO technique does, and it is a useful alternative method when there is a anteromedial soft tissue damage.

Comparative Study for the Fixation Method in the Danis-Weber Type B Lateral Malleolar Fractures: An Antiglide Plate Fixation versus A Lateral Plate Fixation / 대한족부족관절학회지

PURPOSE: To evaluate the advantages of the antiglide plate fixation procedure for Danis-Weber type B lateral malleolar fractures of ankle compared to other methods of lateral plate fixation. MATERIALS AND METHODS: We reviewed 70 cases that antiglide plate fixation and lateral plate fixation procedures were performed from Mar. 2001 through Mar. 2006. Of the total 70 cases, they were divided into two groups ; 22 cases were treated with the antiglide plate procedure (Group I) and 48 cases were treated with the lateral plate procedure (Group II). The results of the two groups were analyzed both radiographically and clinically using Ankle-Hindfoot scale of the American Orthopedic Foot and Ankle Society (AOFAS). RESULTS: All fractures were healed at average of 8 weeks both radiographically and clinically. According to the Ankle-Hindfoot scale, all cases of Group I and 48 cases of Group II were above 80 points. 2 cases (9%) in Group I complained of peroneal tendinitis, while 19 cases (39%) in Group II showed skin irritation resulting from the screw or the plate. A total of 6 cases (27%) in Group I and 27 cases (55%) in Group II complained cosmetic problems. CONCLUSION: we concluded that the antiglide plate fixation for Danis-Weber type B lateral malleolar fractures is one of the good methods. But, further analysis will be need to find a solution for the peroneal tendinitis.

Lateral Plate Fixation in Intercondylar Fracture of the Humerus / 대한정형외과학회잡지

PURPOSE: We reviewed the efficiency of the lateral plate fixation in 15 cases of intercondylar fracture of the humerus. MATERIALS AND METHODS: Fifteen patients was treated by open reduction and internal fixation with lateral plate for intercondyle fracture of humerus. Plate was applied along the lateral aspect of the lateral column and lag screw was inserted in the medial column through the plate. When instability of the medial column was persisted after lateral plating, medial plate was applied posteriorly. RESULTS: There were nine C2 fracture and six C3 fracture by AO/ASIF classification. All of them had comminution at the lateral column. All fractures united at 18.7 weeks in average (range, 10-28 weeks) . Seven cases presented limitation of motion of the elbow joint and five of them underwent adhesiolysis of elbow joint. Finally, range of motion of the elbow joint was flexion contracture 16 degree to further flexion 127 degree in average. Elbow function was classified as thirteen excellent or good, one fair, and one poor. CONCLUSION: In this study, lateral plating with or without medial plate provided suffient rigidity for early motion and was worthful for treatment of the comminuted intercondylar fracture of the humerus.