Less invasive stabilization system for the management of proximal tibia fractures.

BACKGROUND: Proximal tibia fractures are difficult to treat especially when soft tissues are compromised by conventional open reduction and internal fixation with high complication rates. Many methods have been tried to manage these fractures. Less invasive stabilization system (LISS) is the latest technology applied for these injuries. This report presents clinical results of the LISS for the treatment of complex proximal tibia fractures. MATERIALS AND METHODS: From June 2007 to May 2010, total of 35 cases of the proximal tibia fractures (19 AO type 41A, 11 type 41B and five AO type 41C) were treated with the LISS technique. Clinical and radiological evaluation was done at 6, 10, 14, 20, 24 weeks and 9, 12, 18 and 24 months, respectively. RESULTS: The mean age of the patients was 50.17 years (range 20-73 years); male patients were 21 and female 14. The mean follow-up time was 31.42 months (range 21-42 months). The patients were evaluated using Knee Society scores, and the mean score was 92.11 (range 84-100); the mean full weight bearing time was 15.8 weeks (range 12-22), and union time was 25.17 weeks (range 20-29). Superficial infections and slight mal-alignment were seen on five patients each. CONCLUSION: The less invasive stabilization internal fixator system can be used successfully to treat complex proximal tibia fractures with minimal complications. It can be an alternative method for the treatment of the proximal tibia fractures.

Minimally invasive plate osteosynthesis for distal tibial fractures.

PURPOSE: To review the outcomes of 53 patients who underwent minimally invasive plate osteosynthesis (MIPO) for distal tibial fractures. METHODS: Medical records of 31 men and 22 women aged 22 to 78 (mean, 51) years who underwent MIPO using a locking compression plate for distal tibial fractures of the left (n=28) and right (n=25) legs with or without intra-articular extension were reviewed. RESULTS: Patients were followed up for a mean of 26 (range, 24-38) months. The mean time from injury to surgery was 9 (range, 3-12) days. The mean operating time was 105 (range, 75-180) minutes. The mean hospital stay was 16 (range, 8-25) days. Non-weight bearing walking with a crutch was started after a mean of 5.7 (range, 3-9) days. The mean time to callus formation was 12 (range, 8-15) weeks. The mean time to full weight bearing was 15 (range, 8-22) weeks. The mean time to bone union was 25 (range, 20-30) weeks. All except 2 fractures united anatomically. At 10 months, the range of motion of the ankle joint in all patients was similar to the contralateral side. Two patients had malunion but this was not clinically significant. Five patients had superficial infection, and 2 patients had persistent pain. CONCLUSION: MIPO is effective for closed, unstable fractures of the distal tibia. It reduces surgical trauma and preserves fracture haematoma.

Minimally invasive plate osteosynthesis in the treatment of isolated ulnar bone fractures.

BACKGROUND: Minimally invasive internal fixation is also called "biological internal fixation". This concept is used widely in the treatment of various fractures but to date, there have been no report about such application in the repair of isolated ulnar bone fractures. METHODS: Eleven patients with fracture of isolated ulnar bone (four AO type 22A11 and seven AO type 22A12), mean age 43.16 (range, 24- 59y), were treated using closed reduction and locking compression plate with minimally invasive plate osteosynthesis (MIPO) with the aim of minimising soft tissue damage. RESULTS: Fractures healed at an average of 7.8 weeks with good to excellent clinical outcomes. There were no complications such as nonunion, implant failure or neurovascular injuries. CONCLUSIONS: MIPO seems to be advantageous for soft tissue and bone biology. Good union was seen and fracture complications were also prevented by early mobilisation. KEY WORDS: Locking compression plate (LCP), closed reduction, isolated ulnar bone fracture, minimally invasive plate osteosynthesis (MIPO).