Abstract
Introduction: This study was designed to investigate the feasibility and advantages of minimally invasive plate osteosynthesis of tibia fractures.
Methods: In a prospective study, 24 cases of unstable tibial fractures were stabilized with a narrow LC-DCP (Limited Contact-Dynamic Compression Plate) inserted using minimally invasive percutaneous plate osteosyn-thesis technique. The technique consisted of 3 major steps: 1) reduction of fracture with or without distractor; 2) pre-contoured plate insertion percutaneously at the stab incision distant to fracture site; 3) plate fixation to the tibia percutaneously inserted screw. All the procedure was done under fluoroscopic guide. Between January 1998 and March 1999, we operated 16 proximal or distal periarticular fractures, 5 segmental fractures, and 3 mid-shaft fractures of adolescents that had still open physis. 18 fractures were closed, and 4 were open.
Results: 22 of 24 cases healed without second procedures such as bone graft or correction of angular deformity. There was no infection except 1 case of superficial infection that was healed with early removal of plate. There were 3 cases of screw breakage, but no procedure was required. At the follow-up, 2 patients were healed with > 5 degree varus alignment and > 10 degree internal rotation. All the patients had good knee or ankle function.
Conclusion: The authors feel confident that the minimally invasive technique for plate osteosynthesis of tibial fractures that would be inappropriate for intramedullary nailing will prove to a feasible and worthwhile method of stabilization, while avoiding the severe complications associated with the other methods.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
