EVALUATION OF TREATMENT OF DISTAL TIBIAL ARTICULAR AND NON ARTICULAR FRACTURES BY OPEN REDUCTION AND FIXATION BY THE INVERTED CONTOURED T-PLATE
Nehad El Mahboub
Department of Orthopedic Surgery, Misr University for Science and Technology
Background: The optimal treatment of distal tibial articular and non-articular fractures has not been well-defined. Recommendations for surgical treatment include open plating, percutaneous plating and external fixation. Distal tibial fractures may be the result of high energy trauma with multiple metaphyseal fragments and displaced articular fragments with severe soft tissue injury. Another type of these fractures is the result of low energy trauma with a spiral fracture and minimal soft tissue injury.
Objective: The primary concern of this study was to evaluate the results of open anatomical reduction and internal fixation by inverted contoured T-plate and the selection of cases through the determined criteria to minimize soft tissue complications.
Patients and methods: Twenty distal tibial articular and nonarticular fractures were treated by open reduction and internal fixation by using the inverted contoured T-Plate and fixation of the fibula if fractured by a plate in Misr University for Science and Technology Hospital during the period from July 2005 to December 2006, the follow up period ranged from 6-12 month.
Results: All cases united without a second procedure from 14 to 20 weeks with average 15.1 weeks. According to the subjective, objective and radiographic categories of Baird and Jackson there were 6 cases with excellent results, 12 patients with good results, 1 patient with fair result and 1 with poor result.
Conclusion: Open reduction and internal fixation by the inverted contoured T-plate and with the criteria determined for patient selection is an effective method for treatment of distal tibial articular and non-articular fractures allows anatomical reduction, rigid internal fixation and minimize soft tissue complications.