Complications of locking plate fixation in complex proximal tibia injuries.

Abstract:

OBJECTIVES:To report the complications and pitfalls in the treatment of complex injuries of the proximal tibia when locking plates are used. DESIGN, SETTING, AND PATIENTS:This was a retrospective case series conducted at a university Level I trauma center. Thirty-seven patients with complex proximal tibia fractures (41C1, 41C2, 41C3, 41A2, 42A2) were treated with locking plates. INTERVENTION:All fractures were treated with locking plates (Less Invasive Stabilization System (LISS); Synthes, Paoli, PA). MAIN OUTCOME MEASUREMENTS:Healing, alignment, infection, and other complications. RESULTS:Twelve fractures (32%) healed without any complications. Eight patients (22%) developed deep infections that required operative debridements, and 5 of them had a hardware removal; 1 eventually required an above-knee amputation. Eight cases (22%) had postoperative malalignment, with hyperextension as the most common deformity. Three cases (8%) had loss of alignment into varus during healing. Other complications were 1 superficial wound dehiscence, 1 delayed soft-tissue breakdown, 4 hardware irritations, 1 peroneal nerve injury at the distal part of a 9-hole plate, 1 tibial tubercle nonunion, and 1 postoperative compartment syndrome. CONCLUSION:The complication rate, particularly infection, was higher than in previous reports. Other complications such as hardware prominence, malalignment, and loss of alignment were similar to those of historical controls. Some of the complications may reflect the techniques that were used and should decrease with more experience; however, some may be inherent in the treatment of high-energy fractures using locking plates.

journal_name

J Orthop Trauma

authors

Phisitkul P,McKinley TO,Nepola JV,Marsh JL

doi

10.1097/BOT.0b013e318030df96

subject

Has Abstract

pub_date

2007-02-01 00:00:00

pages

83-91

issue

2

eissn

0890-5339

issn

1531-2291

pii

00005131-200702000-00001

journal_volume

21

pub_type

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