Treatment of comminuted tibial shaft fractures using locking compression plating and bridging

Abstract

Objective To evaluate clinical outcomes of locking compression plating (LCP) and bridging techniques for comminuted tibial shaft fractures.Methods From January 2005 to March 2010,78 patients with comminuted tibial shaft fractures were treated with LCP and bridging. They were 46 men and 32 women, with an average age of 36.4 years (from 23 to 69 years). There were 41 left and 37 right fractures. All the cases were of type 42C fracture according to AO classification, including 38 cases of C1, 26 cases of C2 and 14 cases of C3. Sixty-three cases were close and 15 cases were open fractures. For close fractures, a 4.5/5.0 mm LCP was inserted percutaneously with bridging technique after soft tissue swelling subsided, and the same surgical procedure was performed for open fractures after standard debridement. Hip and knee joint movements and muscle strength exercises of the affected lower extremity were encouraged for all patients after surgery.Results The average follow-up was 19 months (from 6 to 35 months). No cases suffered infection and fracture unions averaged 22 weeks (from 13 to 42 weeks) . Seventy-seven patients achieved bony consolidation, but one patient sustained hardware failure due to nonunion. The last follow-ups revealed the mean range of motion of the knee was 123° (from 100° to 130°), the mean Hospital for Special Surgery (HSS) score of the knee was 92.1 points (from 89 to 96 points) and the mean American Orthopaedic Foot and Ankle Society (AOFAS) score of the ankle was 93.6 points (from 82 to 97 points).Conclusion For a comminuted tibial shaft fracture, because intemal fixation with bridging LCP can lead to reliable stability and earlier rehabilitation for the patient, it is one of the optimal options. Key words: Tibial fractures;  Bone plates;  Fracture fixation, internal

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