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International Orthopaedics

, 32:697 | Cite as

Wound complication of minimally invasive plate osteosynthesis in distal tibia fractures

  • T. W. LauEmail author
  • F. Leung
  • C. F. Chan
  • S. P. Chow
Original Paper

Abstract

Nowadays, the use of minimally invasive plate osteosynthesis (MIPO) in the management of fracture of the distal tibia is common. The various advantages of the MIPO technique, namely, preserving blood supply and better bone healing, have been described extensively in the literature. However, this technique is not without complication. Among all the complications, infection is one of the commonest. In the last 3 years, we have performed 48 cases of MIPO in treating distal tibia fractures. Our study was to evaluate the clinical outcome of these cases, with special attention to the infection rate and our experience in managing these infection cases. Our results showed that the average time until the patient started to bear full weight was 9.4 weeks. The average time for bony union was 18.7 weeks. There were 7 cases of late infection among these 48 cases. The rate was 15%. The presence of late infection had no obvious effect on the time to bony union. Twenty-five patients (52%) had the implants removed and the most common reason was skin impingement by the implant. The clinical presentation and management of these late infections are discussed. In conclusion, MIPO fixation of distal tibia fractures using a metaphyseal locking plate is safe and efficient. However, complications such as late wound infection and impingement are relatively common. The overall clinical outcome is still good despite the presence of these complications.

Keywords

Late Infection Methicillin Resistant Staphylococcus Aureus Distal Tibia Distal Fragment Bony Union 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

L’utilisation d’une plaque par technique mini invasive (MIPO) dans le traitement des fractures distales du tibia est relativement fréquente. L’avantage de cette technique est de préserver la vascularisation et d’avoir une meilleure consolidation de l’os. Cependant cette technique n’est pas sans complications. Parmi ces complications l’infection est l’une des plus communes et des plus habituelles. Dans les trois dernières années, nous avons réalisé 48 cas de traitement de fractures distales du tibia selon la technique du MIPO. Notre étude nous a permis d’évaluer le devenir de tous ces cas avec une mention spéciale pour le taux d’infection. Le résultat montre que la moyenne de reprise d’appui a été de 9.4 semaines, le temps moyen de consolidation de 18.7 semaines. Il existe 7 cas d’infections tardives, soit un taux de 15%. La présence d’infection tardive n’a pas influé sur le temps de consolidation. 25 patients (52%) ont bénéficié d’une ablation des implants et la demande la plus fréquente d’ablation des implants est secondaire à une gêne au niveau sous-cutané. En conclusion, la fixation des fractures distales du tibia selon la technique MIPO, utilisant une plaque verrouillée est une technique sûre et efficace. Cependant, les complications d’infection tardive et d’une gêne sous cutané du fait du matériel sont relativement habituelles. Néanmoins, on peut considérer que le devenir clinique de ces patients reste bon malgré l’existence des complications.

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • T. W. Lau
    • 1
    Email author
  • F. Leung
    • 1
  • C. F. Chan
    • 1
  • S. P. Chow
    • 1
  1. 1.Department of Orthopaedics and TraumatologyThe University of Hong Kong, Queen Mary HospitalHong KongChina

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