Locking compression plate with minimally invasive plate osteosynthesis in diaphyseal and distal tibial fracture: a retrospective study of 32 patients

Injury. 2007 Mar;38(3):365-70. doi: 10.1016/j.injury.2006.10.024. Epub 2007 Jan 22.

Abstract

With the introduction of Locking Compression Plates (LCP), Minimally Invasive Plate Osteosynthesis (MIPO) has become widely used. The plates act as internal fixators in a bridging manner, thus resulting in secondary bone healing. We retrospectively evaluated the healing pattern and the clinical evolution of diaphyseal and distal tibial shaft fractures over two and a half years in 32 patients (6 females, 26 males). Fractures were classified according to AO classification and included all 42A-C, 43A-B and 43C1-2 types. For open fractures, Gustillo Anderson classification was used. Plates consisted of the 4.5mm LCP and 3.5mm LCP-Pilon form plate. Clinical and radiological assessment was performed at 6 weeks, and at 3, 6, 9, and 12 months. Two patients were lost to follow-up. Fracture healing was defined as callus bridging of one cortex, seen on both lateral and posterior-anterior X-ray, and full, painless weight bearing. Ten patients at 3 months, 23 at 6 months, and 27 at 9 months met the criteria for a healed fracture. Plate bending was observed in one patient and called for re-operation at 5 months. Two patients required re-operation at 13 months secondary to pseudoarthrosis. Though MIPO seems more advantageous for soft tissue and bone biology, prolonged healing was observed in simple fracture patterns when a bridging plate technique was used.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bone Nails
  • Bone Plates*
  • Bone Regeneration*
  • Bone Screws
  • Diaphyses / surgery
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / instrumentation*
  • Fracture Fixation, Internal / methods
  • Fracture Healing
  • Fractures, Open / surgery*
  • Humans
  • Male
  • Middle Aged
  • Range of Motion, Articular
  • Retrospective Studies
  • Tibia / surgery*
  • Tibial Fractures / surgery*
  • Weight-Bearing