DOS Kongressen 2014 ·
147
Complications and Functional Outcome after Locking
Plate Fixation of Distal Tibial Fractures in the Region of
Southern Denmark 2007-2011
Silje Kleven, Ellen Hamborg Petersen, Bjarke Viberg, Ole Skov
Dept. of Orthopaedic Surgery and Traumatology, Odense University Hospital
Background:
Distal tibia fractures often present a challenge for the orthopae-
dic surgeon and the best treatment remains controversial. Previous research on
locking plates has shown promising results, but we do not know enough about
complications and functional outcome
Purpose / Aim of Study:
To assess the rate of complication and the long-term
functional outcome in patients with distal tibial fractures treated with a low-
profile locking plate
Materials and Methods:
A historical case-series of 70 patients with 71 distal
tibial fractures treated with low-profile locking plate between January 2007
and April 2011 was retrieved. Patient-, injury- and treatment characteristics as
well as information of post-operative complications were retrieved from elec-
tronic health records and patient interviews. Complications were classified as
minor complications and major complications. Long-term functional outcome
was assessed by EQ5D-5L, AOFAS score, and return to pre-injury job function
through patient interview and examination
Findings / Results:
There were 32 43A, 5 43B and 34 43C- fractures, 12
open and 10 high-energy fractures. 49 cases (69%) experienced complica-
tions during the follow-up time, of which 34 were minor and 15 were major
complications. The median (IQR) EQ5D-5L index was 0.76 (0.65-0.84), health
VAS- score 80 (60-90), and AOFAS score 73 (60- 87). Logistic regression
analyses showed that smoking increased the risk of minor complications (OR
23, p<0.018). All other variables showed no statistical significance for minor or
major complications. 33 % of working patients had not returned to work as a
result of the fracture
Conclusions:
Our study suggests that treatment of distal tibial fractures with
low-profile locking plates might have higher rates of complications and worse
functional outcome than previously reported
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