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Avoiding Rotational Mismatch of Locking Distal Tibia Plates Depends on Proper Plate Position

Authors
 Hyung-Keun Song  ;  Jin-Wook Noh  ;  Jae-Hoo Lee  ;  Kyu-Hyun Yang 
Citation
 JOURNAL OF ORTHOPAEDIC TRAUMA, Vol.27(7) : 147-151, 2013 
Journal Title
JOURNAL OF ORTHOPAEDIC TRAUMA
ISSN
 0890-5339 
Issue Date
2013
MeSH
Aged ; Aged, 80 and over ; Ankle Joint/physiology* ; Ankle Joint/surgery* ; Bone Plates* ; Bone Screws* ; Cadaver ; Equipment Design ; Equipment Failure ; Equipment Failure Analysis ; Female ; Humans ; Internal Fixators ; Male ; Prosthesis Fitting/methods* ; Prosthesis Implantation/methods ; Range of Motion, Articular ; Tibia/physiology* ; Tibia/surgery* ; Treatment Outcome
Keywords
distal tibia ; locking plate ; malrotation
Abstract
OBJECTIVES:
The purpose of this study was to evaluate the most appropriate positioning of anatomical locking plates on the distal tibia.
METHODS:
We positioned 4 types of locking plates (3 straight and 1 bayonet) at anterior, middle, and posterior positions on the medial malleolus on both lower limbs of 15 cadavers. We measured the rotational mismatch angle between the tibia and the proximal part of the plate and calculated the plate prominence at each position.
RESULTS:
The average rotational mismatch angles of a combined group containing all 3 straight plates were 0.3, 16.9, and 29.4 degrees at the anterior, middle, and posterior positions, respectively (P < 0.001). In the group with 1 bayonet plate, the rotational mismatch angles were -10.5, 0, and 16.7 degrees on average, respectively (P < 0.001). The average plate prominence for each of the positions (anterior, middle, and posterior) in the group with 3 straight plates were 3.5, 6.9, and 9.4 mm, respectively (P < 0.001). The average plate prominence in the group with 1 bayonet plate were 5.4, 3.6, and 6.7 mm, respectively (P < 0.001).
CONCLUSIONS:
We confirmed that anterior placement of the 3 straight locking plates in the distal tibia showed the best fit with regard to rotational alignment and that middle placement of the bayonet locking plates showed best fit. Placement of distal end of the locking plates in inappropriate positions results in a greater risk of rotational mismatch and plate impingement.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00005131-201307000-00013&LSLINK=80&D=ovft
DOI
10.1097/BOT.0b013e31827cd67d
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Yang, Kyu Hyun(양규현) ORCID logo https://orcid.org/0000-0001-7183-588X
Lee, Jae Hoo(이재후)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87311
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