Jing-Wei Zhang,Nabil A. Ebraheim,Ming Li,Xian-Feng He,Joshua Schwind,Li-Mei Zhu,Yi-Hui Yu.[J].Chin J Traumatol,2016,19(2):104-108. [doi]
Distal tibial fracture: An ideal indication for external fixation using locking plate
  
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KeyWord: Tibia fractureSurgeryExternal fixationLocking plate
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Jing-Wei Zhang Orthopaedic Surgery, Ningbo 6th Hospital, 1059 East Zhongshan Road, Ningbo 315040, Zhejiang Province, China 
Nabil A. Ebraheim Department of Orthopaedic Surgery, University of Toledo, Toledo, OH 43614, USA 
Ming Li Orthopaedic Surgery, Ningbo 6th Hospital, 1059 East Zhongshan Road, Ningbo 315040, Zhejiang Province, China 
Xian-Feng He Orthopaedic Surgery, Ningbo 6th Hospital, 1059 East Zhongshan Road, Ningbo 315040, Zhejiang Province, China 
Joshua Schwind Department of Orthopaedic Surgery, University of Toledo, Toledo, OH 43614, USA 
Li-Mei Zhu Orthopaedic Surgery, Ningbo 6th Hospital, 1059 East Zhongshan Road, Ningbo 315040, Zhejiang Province, China 
Yi-Hui Yu Orthopaedic Surgery, Ningbo 6th Hospital, 1059 East Zhongshan Road, Ningbo 315040, Zhejiang Province, China 
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Abstract:
      Objective: To evaluate the feasibility and efficiency of one-stage external fixation by using locking plate in distal tibial fractures. Methods: In this non-control prospective study, 28 patients with distal tibial fractures were included and underwent one-stage external fixation by using locking plate. There were 21 males and 7 females, with a mean age of 43 years (19-63). According to AO/OTA fracture classification, there were 9 cases of Type A1, 9 of Type A2, 10 of Type A3 fractures. There were 21 close and 7 open fractures. The locking plate was placed on the anteromedial aspect of the tibia with 4e5 bicortical screws inserted in both distal metaphysis and diaphysis. The radiographic and clinic results were evaluated. Results: All patients were followed up for the average of 16 months (ranging from 12 to 21 months). The average surgery duration was 38 (25-60) minutes. The mean time to fracture healing were 14.6±2.67, 17.5 ± 3.66, and 18.4±3.37 (p<0.05) weeks in type A1, A2, and A3 fractures respectively. By the end of the follow-ups, the mean AOFAS score were 96.11±2.32, 92.67±1.80 and 92.00±2.06 (p>0.05) in type A1, A2, and A3 fractures respectively. None of nonunion, deep infection, or breakage of screw or plate were observed. Conclusions: Distal tibial fracture was the ideal indication for external fixation using locking plate. The external plating is characterized by ease of performance, less invasive, fewer soft tissue impingement, improved cosmesis, and convenient for removal.
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