Medial Platting of Distal Tibial Fractures Why & When?
Iraqi Postgraduate Medical Journal,
2018, Volume 17, Issue 2, Pages 121-130
Distal tibial fractures , it’s an extra-articular distal third tibial fractures that extend for 4-11 cm proximal to tibial plafond , it represent a significant challenge to most of the orthopedic surgeon because the tibial bone is subcutaneously located with poor vascularity & because of the thin & delicate soft tissue covering medially; this may lead to a big conflict on choosing the optimum fixation methods
To clarify why & when we use a medial plating for distal tibia, explaining the indication ,advantage-disadvantage, surgical procedure & complications.
PATIENTS AND METHOD:
This is a prospective study conducted on 20 patients with distal tibial shaft fracture (15 male and 5 female) with the mean age of 34 years range from (18 y. to 55 y). operated between the periods from January 2015 to July 2016. All were presented with closed distal tibia fractures , treated by open reduction and internal fixation using a DCP plate and screws fixed on the medial surface of the tibia.
-All patients had a complete union in 4- 6 months except 2 patients (10%) with delayed union. we have 14 cases (70%) with an excellent result, 5 cases (25%) with a good result, one case (5%) end with fair result (6° varus deformity) , we had only one case with superficial infection treated properly & three cases with wound dehisces 15%, 2 patients (10%) developed a delayed union treated with bone graft .. CONCLUSION :
Open reduction & internal fixation by medial platting for distal tibia fracture using DCP plate, had a biomechanical advantage applying both compression and torsional loading force when used to stabilize varus fracture pattern of distal tibial fracture
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