Lower Limb Malrotation following Minimally Invasive Plating in Distal Tibia Fractures
https://doi.org/10.5704/MOJ.2403.018
- Author:
Yap WMQ
1
;
Ng JW
2
;
Lee MJJR
2
;
Kwek EBK
2
Author Information
1. Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore
2. Department of Orthopaedic Surgery, Woodlands Health, Singapore
- Publication Type:Journal Article
- Keywords:
distal tibia fracture, MIPO, minimally invasive, percutaneous, open reduction and internal fixation
- From:Malaysian Orthopaedic Journal
2024;18(No.1):140-149
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Minimally invasive percutaneous
osteosynthesis (MIPO) plating techniques have
demonstrated good outcomes in the treatment of distal tibia
fractures. Early arthritis and functional impairment may
occur if length and rotation are not restored. This study aims
to determine the incidence and severity of tibia malrotation
following MIPO plating of isolated unilateral distal tibia
fractures, defined as torsional difference of greater than 10°
as compared to the contralateral limb and whether the degree
of malrotation affects functional outcomes scores.
Materials and methods: This was a level 2 prospective
cohort study. All patients with fractures of the distal tibia
who underwent surgical fixation with the exclusion of
patients with polytrauma, neurovascular injuries or preexisting disabilities were recruited. Patients underwent
MIPO plating followed by a post-operative Computed
Tomography (CT) scan of bilateral lower limbs. AOFAS
ankle-hindfoot score was recorded at six months and one
year follow-up.
Results: A total of 24 patients (28 to 83 years old) were
recruited. Nineteen patients obtained CT scans. Nine of the
19 patients (47.3%) had tibia malrotation. The mean tibia
malrotation angle was 10.3° (0° - 45°). The average AOFAS
scores was 82.4 and 84.3 at 6 months and 1 year follow-up.
Degree of CT malrotation was not significantly associated
with AOFAS scores at 6 month (spearman rho -0.386) and 1
year (spearman rho -0.343).
Conclusions: Tibia malrotation following MIPO plating of
distal tibia fractures is common, with an incidence of 47.3%
and an average malrotation angle of 10.3°. The degree of
malrotation does not appear to have significant mid-term
functional impact on the patient.
- Full text:202408141236556366316.2024my1362.pdf
