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Comparative Study
. 2013 Apr;37(4):701-8.
doi: 10.1007/s00264-013-1820-x. Epub 2013 Feb 16.

Minimally invasive and open surgical treatment of proximal tibia fractures using a polyaxial locking plate system: a prospective multi-centre study

Jens A Jöckel  1 , Johannes Erhardt, Miscia Vincenti, Jörg Reissig, Reinhard Hoffmann, Baher Husain, Gert Täger, Axel Partenheimer, Helmut Lill, Florian Gebhard, Götz Röderer
Affiliations
Comparative Study

Minimally invasive and open surgical treatment of proximal tibia fractures using a polyaxial locking plate system: a prospective multi-centre study

Jens A Jöckel et al. Int Orthop. 2013 Apr.

Abstract

Purpose: The purpose of this study was to determine whether a polyaxial locking plate of the latest generation (NCB PT(®), Zimmer Inc.) which can be applied both open and minimally invasively, can be used as a routine method of treatment for proximal tibia fractures.

Methods: Eighty-six patients (35 women, 51 men; mean age 51 years) were enrolled in this prospective multicentre trial. Ninety-six percent of the fractures were intra-articular (AO type B and C); 36 % were treated open and 64 % minimally invasively. Follow-up was obtained three, six and 12 months after surgery.

Results: No implant failure occurred. At 12 months, the functional result using a knee-specific score was good to excellent in 95 %, and 99 % of the fractures were radiologically healed.

Conclusion: The system is a versatile implant for proximal tibia fracture treatment. Polyaxiality and a specific locking mechanism are compatible with different fracture patterns. The minimally invasive technique effectively protects soft tissues but should not be performed at the expense of fracture reduction. Early functional results and complication rate are comparable to those in the literature.

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Figures

Fig. 1
Fig. 1
Polyaxial screw locking mechanism (left) and the non contact principle (right). By inserting the cap the convexity of the screw penetrates below the lower plate surface and thus reduces the contact pressure between plate and bone (images from Zimmer Inc.)
Fig. 2
Fig. 2
Radiolucent targeting guide with attached NCB PT plate for the minimally invasive surgical technique (images from Zimmer Inc.)
Fig. 3
Fig. 3
HSS (Hospital for Special Surgery) score and ROM (range of motion) after the 3-, 6- and 12-month follow-up
Fig. 4
Fig. 4
SF12 (Short Form) prior to the accident (baseline) and after the 3-, 6- and 12-month follow-up
Fig. 5
Fig. 5
X-ray series of an AO 31-C2 type fracture after minimally invasive treatment with an NCB PT plate. a Pre-surgery. b Post-surgery. c After 3 months. d After 6 months
See this image and copyright information in PMC

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