Individualized custom plates to treat fractures around the knee and ankle joints

Abstract

Objective To explore the therapeutic effects of individualized custom plates in the treatment of fractures around the knee and ankle joints. Methods From March to September 2011,13 patients with fractures around the knee and ankle joints were treated in our department.They were all male,aged from 19 to 64 years (average,39.8 years).According to AO classification,there were one case of type B and 12 of type C.One patient had a distal femoral fracture,6 had a proximal tibial fracture and 6 had a distal tibial fracture. Three-dimensional reconstruction of the fracture was conducted by means of software Mimics 10.01 after CT scanning (0.7 mm per slice) for virtual simulation of the operation.The plates and screws were manufactured after computer-assisted design using software UG NX7.0.Minimally invasive plate osteosynthesis (MIPO) was applied after local detumescence to fixate the fractures with individualized custom plates and screws. Results The average following-up period was 11.1 months,ranging from 7 to 13 months.The average time for fracture healing was 12.8 weeks,ranging from 9 to 33 weeks.No nonunion was found during the follow-up.According to the Neer and Baired-Jackson scoring systems for the knee and ankle joints,the functional recovery was evaluated as excellent in 9 cases,good in 3 cases and fair in one case.The good to excellent rate was 92.3％. Conclusions Virtual simulation of the internal fixation can be conducted pre-operation with an individualized custom plate to ensure satisfactory effects.Individualized custom plates and MIPO may achieve positive outcomes for fractures around the knee and ankle joints. Key words: Knee;  Ankle; Surgery,computer-assisted;  Fracture fixation, internal; Peri-articular fracture

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