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Erschienen in:
01.09.2015 | Original Article
Faster return to job and sports after antegrade plate insertion in minimally invasive plating of distal tibia fractures
Erschienen in: European Orthopaedics and Traumatology | Ausgabe 3/2015
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Background
Minimally invasive plate osteosynthesis (MIPO) became an important option for treating distal tibia fractures. All the surgeons insert the plate from distal to proximal (retrograde), but we used antegrade plate insertion, if the distal fragment is displaced laterally in relation to the proximal fragment and vice versa. We noticed less soft tissue complications at the distal incision with antegrade plate insertion.
Methods
In this retrospective cohort study, we reviewed our patients for whom we used MIPO to treat distal tibia fractures, either through antegrade or retrograde plate insertion. We could match 22 patients treated with antegrade plate insertion (group A) to another 22 patients treated with retrograde plate insertion (group B). As per AO classification, 26 fractures were type A, 14 type B, and 4 type C. Statistical analyses were performed in SPSS version 20, and P value less than 0.05 was considered significant.
Results
The antegrade group showed a statistically significant better results with reference to length of the distal incision (P = 0.000), AOFAS score (P = 0.025), the time to return to job (P = 0.000), sports practice (P = 0.046), the time to return to sports (P = 0.002), and the number of received physiotherapy treatments (P = 0.000).
Conclusions
Both modes of plate insertion were safe and effective in treating distal tibia fractures. Antegrade plate insertion minimizes additional trauma to the already traumatized zone, showed less complications, and better functional results. Faster return to job and sports support antegrade plate insertion to be preferred for athletic persons. A prospective comparative study is recommended.