• Cory Collinge and Robert Protzman.
• Division of Orthopedic Trauma, Harris Methodist Fort Worth Hospital, Fort Worth, TX, USA. ccollinge@msn.com
• J Orthop Trauma. 2010 Jan 1; 24 (1): 24-9.

ObjectiveEvaluation of clinical results and outcomes of low metaphyseal distal tibia fractures with minimal or no intra-articular involvement. These were treated using the minimally invasive plate osteosynthesis concept with a 3.5-mm locked medial tibial plafond plate and hybrid (locking and nonlocking) screw construct.SettingLevel II regional trauma center.DesignConsecutive case series of clinical outcomes using limb-specific and whole-person measures.InterventionMinimally invasive medial plating using hybrid locking and nonlocking techniques.Main Outcome MeasurementThe following were applied at a minimum of 2 years: limb assessment--Olerud and Molander's ankle rating scale and the American Orthopaedic Foot and Ankle Surgeon's (AOFAS) ankle-hindfoot instrument, whole-person assessment--the Short Form 36 (SF-36).ResultsThirty-eight patients were followed an average of 32 months (range, 12-48 months). Mean fracture healing time was 21 weeks (range, 9-60 weeks). Acceptable alignment and length were restored (angulation 2 years, the AOFAS and the Olerud and Molander ankles scores averaged good-excellent. SF-36 outcomes scores were lower than that of normative data in patients with uninjured limbs but only significantly diminished in physical function.ConclusionsMinimally invasive medial plating using a hybrid locking plate technique in metaphyseal fractures of the distal tibia predictably restored limb alignment with a 5% reoperation rate and yielded mostly good-excellent ankle scores. There were residual impairments seen on whole-body outcomes measures.

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