Double plating of unstable proximal tibial fractures using minimally invasive percutaneous osteosynthesis technique.

摘要

BACKGROUND: Double plating of proximal tibial fractures with traditional open osteosynthesis gives a stable fixation, but may be complicated by wound healing problems. Minimally invasive methods have been recommended to decrease the wound complication rates. We report the efficacy of double plating of proximal tibial fractures using a minimally invasive percutaneous technique. PATIENTS AND METHODS: 23 proximal tibial fractures in 23 patients (mean age 54 (36-78) years) were treated with double plating using a minimally invasive percutaneous technique. Functional and radiographic results were evaluated by a modified Rasmussen scoring system. RESULTS: All fractures healed. The average time for fracture healing was 19 (10-32) weeks. 21 patients had excellent or good clinical and radiographic results. 2 patients had a fair clinical result because of associated knee injuries. Complications included 1 case of shortening (1 cm) and 2 cases of mild malalignments (varus less than 10 degrees ). There was 1 case of superficial infection that healed after removal of the plate. No deep infections occurred. INTERPRETATION: Double plating using minimally invasive percutaneous technique can provide favorable results in the treatment of proximal tibial fractures.