Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Treatment of Distal Tibia Fracture using MIPPO Technique with Locking Compression Plate: Comparative Study of the Intraarticular Fracture and Extraarticular Fracture

잠김-압박 금속판을 사용하여 MIPPO 수기를 적용한 원위부 경골 골절의 치료: 관절내 골절과 관절외 골절의 비교

  • Chung, Soo-Tae (Department of Orthopaedic Surgery and Pathology, Myongji Hospital, Kwandong University College of Medicine) ;
  • Kim, Hyung-Soo (Department of Orthopaedic Surgery and Pathology, Myongji Hospital, Kwandong University College of Medicine) ;
  • Cha, Seung-Do (Department of Orthopaedic Surgery and Pathology, Myongji Hospital, Kwandong University College of Medicine) ;
  • Yoo, Jeong-Hyun (Department of Orthopaedic Surgery and Pathology, Myongji Hospital, Kwandong University College of Medicine) ;
  • Park, Jai-Hyung (Department of Orthopaedic Surgery and Pathology, Myongji Hospital, Kwandong University College of Medicine) ;
  • Kim, Joo-Hak (Department of Orthopaedic Surgery and Pathology, Myongji Hospital, Kwandong University College of Medicine) ;
  • Jung, Jin-Ha (Department of Orthopaedic Surgery and Pathology, Myongji Hospital, Kwandong University College of Medicine)
  • 정수태 (관동대학교 의과대학 명지병원 정형외과학교실) ;
  • 김형수 (관동대학교 의과대학 명지병원 정형외과학교실) ;
  • 차승도 (관동대학교 의과대학 명지병원 정형외과학교실) ;
  • 유정현 (관동대학교 의과대학 명지병원 정형외과학교실) ;
  • 박재형 (관동대학교 의과대학 명지병원 정형외과학교실) ;
  • 김주학 (관동대학교 의과대학 명지병원 정형외과학교실) ;
  • 정진하 (관동대학교 의과대학 명지병원 정형외과학교실)
  • Published : 2009.12.15
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Abstract

Purpose: To evaluate the efficiency of the minimally invasive percutaneous plate osteosynthesis (MIPPO) with locking compression plate (LCP) for distal tibial metaphyseal intra-articular fracture compared with extra-articular fracture. Materials and Methods: From February 2006 to June 2008, 21 patients with distal tibia metaphyseal intra-articular fracture and 20 patients with extra-articular fracture were treated operatively by MIPPO technique with LCP and followed for at least one year. In the group with intra-articular fracture, mean age was 48.85 years old and a mean follow-up was 15 months. In the other group with extra-articular fracture, mean age was 52.35 years old and a mean follow-up was 14.5 months. The type of fracture was evaluated using the AO/OTA classification and open-fractures were according to the Gustilo-And gron classification. Radiologic evaluation with fracture healing and tibial alignment, clinical evaluation with Olerud and Molander ankle score and restriction of motion were done for treatment. Results: According to AO/OTA classification, There were 21 type A, 15 type B, 5 type C. Average union time of the intra-articular fracture (type B, C) was 18.7 weeks. Average union time of the extra-articular fracture (type A) was 17.1 weeks. All fractures were healed without malunion. There were no difference of mean restriction angle between intra-articular fracture (ankle dorsiflexion was 3.57 degree, plantar-flexion was 5.95 degree) and extra-articular fracture (ankle dorsiflexion was 3 degree, plantar-flexion was 3.75 degree). There were no difference of Olerud and Molander ankle score between them as a mean score of intra-articular and extra-articular was 89.25, 91.25 each other. As a complication, there were 3 case of skin necrosis, 8 case of discomfortable skin tenting by plate and 1 superficial infection, but could be healed by conservative care. Conclusion: MIPPO technique, combined articular reduction, with LCP of distal tibial metaphyseal fracture was a good method with high functional recovery.

Keywords

References

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