Staged protocol in treatment of open distal tibia fracture: using lateral MIPO

• Published in: Clinics in orthopedic surgery 2011, 3(1), , pp.69-76
• Main Authors: Sohn, Oog Jin, Kang, Dong Hwa
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Ankle; Ankle Injuries - surgery; Bone grafts; Bone healing; Bone Transplantation; Classification; Clinical Protocols; Debridement; External Fixators; Female; Fracture Fixation, Internal - methods; Fractures; Fractures, Open - surgery; Humans; Injuries; Joints; Male; Middle Aged; Negative-Pressure Wound Therapy; Nonunion; Original; Osteosynthesis; Recovery of function; Therapeutic Irrigation; Tibia; Tibial Fractures - surgery; Treatment Outcome; Wound infection; 정형외과학
• ISSN: 2005-291X; 2005-4408
• DOI: 10.4055/cios.2011.3.1.69

To evaluate the radiological, clinical results in patients with open distal tibia factures, who were treated with a staged treatment protocol using the lateral minimally invasive plate osteosynthesis (MIPO) technique. From January 2007 to June 2009, 10 patients with open distal tibia fractures (Gustilo-Anderson classification II, 3; IIIA, 1; IIIB, 6) were treated using a staged treatment protocol. The initial debridement and application of an external fixator were performed within 24 hours and the mean interval from injury to definitive surgical treatment was 15 days (range, 6 to 52 days). Eight weeks later, an additional bone graft was performed in 3 patients. The follow-up duration was more than 1 year. The mean fracture healing time was 21 weeks (range, 17 to 28 weeks), and the average Iowa ankle rating score was 84.5 points. At the last follow-up, there was no non-union, angular deformity > 5°, shortening > 10 mm or infection. In 10 patients, 2 patients had a superficial wound infection, and another 2 patients showed limitation of ankle joint motion. This staged treatment protocol using a lateral MIPO technique is a useful alternative method for achieving high functional recovery with good healing and low complication rates in patients with an open distal tibia fracture.