Medial versus lateral locking plate for fixation of distal tibial fractures / 中国组织工程研究

ABSTRACT

BACKGROUND:With the increasing incidence of distal tibial fractures, locking plate fixation has become the preferred internal fixation method. OBJECTIVE:To analyze the biomechanical performance of distal tibial fractures, and to study the difference between medial and lateral locking plate methods for internal fixation of distal tibial fractures. METHODS:Articles concerning the biomechanics of the internal fixation of distal tibial fractures were col ected by literature search. The articles that met the criteria were analyzed in depth. In this paper, a biomechanical comparison between locking plate fixation and intramedul ary nail fixation was done as wel as the stress distribution and mechanism of the ankle joint. Meanwhile, 60 patients with distal tibial fractures who had received medial or lateral locking plate fixation at the Department of Orthopedics, Chongming Branch, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China from January 2009 to January 2012 were enrol ed for efficiency comparison. RESULTS AND CONCLUSION: For patients with distal tibial fractures, it is easy to cause posterior mal eolus fractures, Y-shaped fractures and anterior tibial compression, respectively, in the plantar flexion position, neutral position, and dorsiflexion position. Locking plate is better than the intramedul ary nail in the torsional force, and the intact fibula contributes to the improvement of fixed effects of these two internal fixation methods. When the fibula cannot be effectively fixed, the locking plate fixation has a better stability than the intramedul ary nail. Moreover, there is no difference in the fracture healing after fixation with medial and lateral locking plates. However, a lower incidence of complications and better function recovery of the ankle joint can be realized after lateral locking plate fixation.