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. 2017 Mar 18;2(1):e000029.
doi: 10.1136/tsaco-2016-000029. eCollection 2017.

Management of diaphyseal tibial fractures by plate fixation with absolute or relative stability: a retrospective study of 45 patients

Juan Manuel Concha Sandoval  1 , José Luis Osma Rueda  2 , Alejandro Sandoval Daza  1
Affiliations

Management of diaphyseal tibial fractures by plate fixation with absolute or relative stability: a retrospective study of 45 patients

Juan Manuel Concha Sandoval et al. Trauma Surg Acute Care Open. .

Abstract

Background: Fixation of diaphyseal tibial fractures by plates is not considered the best option due to complications that may eventually arise; however, if principles of stability and proper surgical techniques are used, it is possible to obtain fracture consolidation without major risks.

Methods: We conducted a cross-sectional observational descriptive study by retrospectively analyzing medical records of patients with diaphyseal tibial fractures that were treated with plates from the period between June 2011 and June 2014 at San José and Susana López Hospitals in the city of Popayan, Colombia. 3 treatment groups were created and analyzed according to the type of fracture (Association Osteosynthesis/Osteosynthesis Trauma Association AO/OTA): group I: simple fractures 42A/B, absolute stability; group II: simple fractures 42A/B, Minimally Invasive Plate Osteosynthesis (MIPO) technique, relative stability; group III: multifragmentary fractures 42C, MIPO technique, relative stability. A descriptive analysis of patients, fracture consolidation time, and complications in each group were performed.

Results: 45 patients with tibial fractures treated with osteosynthesis plates were analyzed. Group I: 14 patients, 42A (n=13) and 42B (n=1), had an average consolidation time of 16.38 (SD=1.98) and 14 weeks, respectively. In group II: 19 patients, out of which 18 achieved fracture consolidation (42A n=15 and 42B n=3) with an average time of 17.4 (SD=3.33) and 17.3 weeks (SD=6.11), respectively. Finally, in group III: 12 patients all with 42C fractures with a consolidation time of 16.86 (SD=2.93) weeks. The average fracture consolidation time for all 44 patients was 16.86 weeks (SD 2.93).

Conclusions: Osteosynthesis plates are an alternative to intramedullary nailing for diaphyseal tibial fractures and their outcomes can be favorable as long as the management of soft tissues and the proper principle of stability are taken into account.

Level of evidence: IV.

Keywords: Plates; internal fixation; tibial fractures.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Fracture reduction with absolute stabilization MIPO technique. (A) Closed reduction with percutaneous pinning of the fracture. (B) Absolute stability of the fracture. (C) Bone healing. MIPO, Minimally Invasive Plate Osteosynthesis.
Figure 2
Figure 2
Open reduction and absolute stability. (A) Fracture and opened reduction. (B) Absolute stability and bone healing. MIPO, Minimally Invasive Plate Osteosynthesis.
Figure 3
Figure 3
MIPO technique relative stability simple fracture 42A. (A) Fracture and closed reduction. (B) Relative stabilization with plate and MIPO. MIPO, Minimally Invasive Plate Osteosynthesis.
Figure 4
Figure 4
Indirect reduction by MIPO technique and relative stabilization using multifragmentary plate fracture 42C. (A) Complete fracture and indirect reduction. (B) Stabilization with plate. (C) Bone healing. MIPO, Minimally Invasive Plate Osteosynthesis.
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