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Does malrotation following MIPO treatment of distal tibia metaphyseal fractures effect the functional results of the ankle and knee joints?

Abstract：

OBJECTIVES:To investigate whether rotational malalignment of tibia, after fracture management with minimally invasive plate osteosynthesis technique (MIPO), leads to impaired results in knee and ankle joint functional scores. DESIGN:Prospectively collected data was retrospectively analyzed for this study. SETTING:Level III academic trauma center.Patients/Participants: 65 consecutive patients who applied between October 2010 and January 2014 with a unilateral distal tibia fracture and had full bone union at their last visit were analyzed. Patients were excluded if they had a pathological fracture, Gustilo-Anderson type II or III open fracture, additional ligamentous trauma, were pregnant, or had any deformity. A total of 27 patients were accepted into the study. INTERVENTION:All patients were treated with a MIPO technique after a mean of 2.8 days. The fibular fracture, when present, was fixed first. MAIN OUTCOME MEASUREMENTS:The main outcome of this study was the relation between tibial malrotation after a MIPO procedure, and LEFS, AOFAS, KOOS scores and range of motions of adjacent joints.ResultsFourteen patients (51.8%) had a rotation higher than 10°. The mean malrotation angle was 14.6°. Concomitant fibular fractures were present in 13 patients, which did not seem to have a significant influence on malrotation. There was no significant difference between groups regarding functional scores and range of motions of the knee and ankle joints. CONCLUSIONS:Despite high rates of malrotation following tibial metaphyseal-diaphyseal fractures treated with MIPO technique, this finding does not seem to have a significantly negative effect on knee and ankle joint functions. Meticulous intraoperative evaluation, through a range of different techniques, should be performed to avoid malrotation. LEVEL OF EVIDENCE:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

journal_name

J Orthop Trauma

journal_title

Journal of orthopaedic trauma

authors

Çepni Ş,Yaman F,Veizi E,Fırat A,ÇayAssoc N,Tecimel O

doi

10.1097/BOT.0000000000002053

subject

Has Abstract

pub_date

2020-12-31 00:00:00

eissn

0890-5339

issn

1531-2291

pii

00005131-900000000-98110

journal_volume

Publish Ahead of Print

pub_type

杂志文章

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Does malrotation following MIPO treatment of distal tibia metaphyseal fractures effect the functional results of the ankle and knee joints?