Double plating for the treatment of distal tibia and fibula fractures: case series of twenty five patients

H. Ma, C. Wang, Q. Wei, Z.H. Li, B.Q. Yu

Department of Orthopaedics Surgery, Shanghai First Rehabilitation Hospital, Shanghai, China. yubaoqingybq@gmail.com

 

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• Orthopedics

BACKGROUND: The treatment of fractures of the distal third of the tibia and fibula usually involves two incisions, thus raising the risk of wound dehiscence, wound necrosis, infection, and the delayed union or non-union of distal tibial fractures. To decrease and prevent aforementioned serious complications, one-incision double-plating technique was advocated here.

AIM: The aim of this work was to evaluate the results and effects of the one-incision, double-plating technique in the fractures of distal third of the tibia-fibula and fibula.

PATIENTS AND METHODS: Twenty-five patients with fractures of the distal third of the tibia-fibula, were treated with one incision, double plating between June 2007 and January 2009. The reduction and fixation of the tibia and fibula were conducted in all patients using one incision. The type of fractures based on AO classification were A1 (n = 6), A2 (n = 4), B1 (n = 12) and C1 (n = 3). All patients were followed-up at least until the patient was fully weight-bearing and the soft tissues had healed (median, 15 months; range, 12-24).

RESULTS: Postoperative follow-up showed that 24 fractures healed within the range of the normal healing time. Only one patient with delayed union healed without surgical intervention by 7 months postoperatively. There were no cases of malunion or non-union. Importantly, at their last follow-up visit, the fracture was in excellent position and healed radiographically, and the patient could walk without pain and support.

CONCLUSIONS: One-incision double-plating is a safe and effective alternative for treatment of distal tibia and fibula fractures.

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