Clinical and radiological outcomes of distal one-third tibial fractures treated with minimally invasive plate osteosynthesis using anatomical locking plates: A prospective observational study.
DOI:
https://doi.org/10.51168/sjhrafrica.v6i12.2400Keywords:
Distal tibia fracture, Minimally Invasive Percutaneous Plate Osteosynthesis, Anatomical locking plate, American Orthopaedic Foot and Ankle Society score, Minimally invasive osteosynthesisAbstract
Background
Fractures of the distal one-third of the tibia are associated with significant treatment challenges due to limited soft-tissue coverage, compromised vascularity, and proximity to the ankle joint. Conventional open reduction techniques are linked to higher rates of wound complications and delayed union. Minimally invasive percutaneous plate osteosynthesis aims to preserve fracture biology while providing stable fixation.
Objective: To evaluate the clinical and radiological outcomes of distal one-third tibial fractures treated using minimally invasive osteosynthesis with anatomical locking plates.
Methods
A prospective observational study was conducted on 30 adult patients with distal one-third tibial fractures treated between January 2021 and January 2024 at Vels Medical College and Hospital, Tiruvallur, Tamil Nadu. Fractures were classified according to the AO/OTA classification. Functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society ankle–hindfoot score. Radiological union, time to union, alignment, and complications were documented over a minimum follow-up of 12 months.
Results
The mean age of patients was 56 ± 15 years. Road traffic accidents accounted for 60% of injuries. The mean time to radiological union was 17.4 ± 5 weeks. Excellent functional outcomes were observed in 83.3% of patients, while 16.7% achieved good outcomes. Complications included superficial infection (10%), deep infection (3.3%), malreduction (6.7%), and delayed union (10%). No cases of nonunion were recorded.
Conclusion
Minimally invasive plate osteosynthesis using anatomical locking plates results in reliable fracture union, excellent functional outcomes, and acceptable complication rates in distal one-third tibial fractures.
Recommendation
Minimally invasive plate osteosynthesis using anatomical locking plates is recommended for adult distal one-third tibial fractures where preservation of soft tissue and fracture biology is critical, particularly in fractures unsuitable for intramedullary nailing.
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