• Indian J Orthop · Nov 2018

    Anatomically Precontoured Locked Plates in Pilon Fractures: A Computed Tomography Based and Cadaveric Study.

    • Hoon-Sang Sohn, Jong-Keon Oh, Ha Sol Yang, and Hyeong Rang Kim.
    • Department of Orthopaedic Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
    • Indian J Orthop. 2018 Nov 1; 52 (6): 665-671.

    BackgroundThe treatment of comminuted tibia plafond fractures remains clinically challenging due to the complexity of the articular fracture pattern despite using the anatomically precontoured locked plates. This study describes the morphologic characteristics of the anterolateral fragment and to evaluate the fixability of the anterolateral fragment with the anatomically precontoured locked plate in the pilon fracture.Materials And MethodsOne hundred and twenty five cases of AO 43-B and C fracture were evaluated using the computed tomography (CT) scan. The anterior-posterior distance in CT (APDc), medial-lateral distance in CT (MLDc), coronal and sagittal height, and articular surface area of the anterolateral fragment were measured in CT. Four types of anatomically precontoured locked plates were used for cadaveric measurement. Four cadaveric parameters were also evaluated; anteroposterior distance in plate (APDp), height of the screw in the medial plate, medial-lateral distance in plate (MLDp), and height of the screw in the anterolateral plate.ResultsThe anterolateral fragment was described with a mean surface area of 167.13 mm2 (APDc: 10.89 ± 4.64 mm, MLDc: 15.02 ± 6.56 mm, sagittal height: 14.85 ± 6.25 mm, and coronal height: 17.27 ± 6.88 mm). The cadaveric measurement showed that the juxta-articular screw of the medial distal tibia plate was placed away from the anterolateral fragment. The anterolateral distal tibia plate did not purchase the anterolateral fragment due to the higher position of the most distal-lateral screw (Synthes 18.37 ± 1.86 mm and Zimmer 17.78 ± 2.37 mm of the height of screw in the anterolateral plate).ConclusionAnatomical distal tibial locked plates did not take purchase on the anterolateral fragment in pilon fracture in the best anatomical fit. Preoperative CT measurement can be used for determining a fixation strategy for the anterolateral fragment. In addition, a newly designed anterolateral distal tibia plate can be another solution when the usual anatomically precontoured distal tibia locked plate fails to cover the anterolateral fragment.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…