1.How Effective is Fibula Pro Tibia Plating in Treatment of Distal Tibial Fractures: A Pilot Study
Jain S ; Khare H ; Verma K ; Kumar U ; Ajmera A
Malaysian Orthopaedic Journal 2024;18(No.2):27-33
Introduction: Despite recent advances, management of
distal tibial fractures is challenging, with high rate of
complications. Fibula pro tibia plating technique fixes fibula
and tibia together, via laterally placed fibular plate without
disturbing the tibial soft tissue sleeve. We contemplated this
pilot study to assess effectiveness of fibula pro tibia plating
in management of distal tibia fibula fractures.
Materials and methods: A total of 30 patients with distal
tibia fibula fractures with fracture line extending within 5cm
from tibial plafond were managed with fibula pro tibia
plating, with or without minimal articular fixation. Outcome
evaluation was done by union, union time, alignment and
functional outcome as assessed by AOFAS score.
Results: Mean age in the series was 39.4 years with male to
female ratio of 3:2. Mean duration of surgery, blood loss and
C arm exposure were 79 minutes (range 52 to 98min), 80ml
(range 62 to 102ml) and 48 shoots (range 36 to 81 shoots),
respectively. All fractures united in mean union time of 10.2
weeks (range 9 to 14 weeks) with acceptable alignment in all
the patients except one. Mean AOFAS score was 86.3 (range
70 to 93) with 29 patients having good to excellent outcome.
One patient had varus malunion and in one case infection
was seen.
Conclusion: Fibula pro tibia plating can be successfully
used to manage complex distal tibia fractures which leaves
the soft tissue and periosteal sleeve undisturbed, thus
avoiding wound related problems and leading to early union.