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Percutaneous plating for unstable tibial fractures
Chang-Wug Oh1, Byung-Chul Park, Hee-Soo Kyung
1Department of Orthopedic Surgery, Kyungpook National University Hospital, 50, 2-Ga, SamDok-Dong, Chung-Gu, Daegu, Korea 700-721.
Summary
Percutaneous plating offers a viable alternative for unstable tibial fractures when intramedullary nailing is challenging. This minimally invasive technique demonstrates high healing rates with minimal complications, preserving limb function.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Skeletal Repair
Background:
- Unstable tibial fractures often present challenges for traditional intramedullary nailing.
- Percutaneous plating offers a minimally invasive approach to fracture stabilization.
Purpose of the Study:
- To evaluate the efficacy and safety of percutaneous plating for unstable tibial fractures.
- To assess outcomes in cases where intramedullary nailing is not ideal.
Main Methods:
- Twenty-four unstable tibial fractures were treated with narrow limited contact-dynamic compression plates.
- A percutaneous plating technique under fluoroscopic guidance was employed.
- Indications included metaphyseal, segmental, and mid-shaft fractures, particularly in adolescents with open physes.
Main Results:
- Twenty-two of 24 fractures healed successfully without secondary procedures.
- Two failures included one requiring bone grafting for comminution and one superficial infection treated with plate removal.
- Minor complications like screw breakage occurred in three cases but did not necessitate further intervention.
- Excellent knee and ankle function was reported in all patients at final follow-up.
Conclusions:
- Percutaneous plating is a safe and effective alternative for unstable tibial fractures.
- This technique minimizes risks associated with infection and soft tissue compromise compared to other methods.
- It provides good functional outcomes for complex tibial fracture patterns.