$Distal tibia fractures: locked or non-locked plating?$

Journal article

Open access

Distal tibia fractures: locked or non-locked plating?

Amrit S Khalsa, Nader Toossi, Loni P Tabb, Nirav H Amin, Kenneth W Donohue and Douglas L Cerynik

Acta orthopaedica, v 85(3), pp 299-304

Jun 2014

DOI: https://doi.org/10.3109/17453674.2014.913226

PMID: 24758325

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Abstract

Background and purpose - Although plating is considered to be the treatment of choice in distal tibia fractures, controversies abound regarding the type of plating for optimal fixation. We conducted a systematic review to evaluate and compare the outcomes of locked plating and non-locked plating in treatment of distal tibia fractures. Patients and methods - A systematic review was conducted using PubMed to identify articles on the outcomes of plating in distal tibia fractures that were published up to June 2012. We included English language articles involving a minimum of 10 adult cases with acute fractures treated using single-plate, minimally invasive techniques. Study-level binomial regression on the pooled data was conducted to determine the effect of locking status on different outcomes, adjusted for age, sex, and other independent variables. Results - 27 studies met the inclusion criteria and were included in the final analysis of 764 cases (499 locking, 265 non-locking). Based on descriptive analysis only, delayed union was reported in 6% of cases with locked plating and in 4% of cases with non-locked plating. Non-union was reported in 2% of cases with locked plating and 3% of cases with non-locked plating. Comparing locked and non-locked plating, the odds ratio (OR) for reoperation was 0.13 (95% CI: 0.03-0.57) and for malalignment it was 0.10 (95% CI: 0.02-0.42). Both values were statistically significant. Interpretation - This study showed that locked plating reduces the odds of reoperation and malalignment after treatment for acute distal tibia fracture. Future studies should accurately assess causality and the clinical and economic impact of these findings.

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Details

Title: Distal tibia fractures: locked or non-locked plating?
Creators: Amrit S Khalsa - 1Department of Orthopedic Surgery, Drexel University College of Medicine
Nader Toossi - 1Department of Orthopedic Surgery, Drexel University College of Medicine
Loni P Tabb - 2 Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA
Nirav H Amin - 3Cleveland Clinic Sports Health Center, Garfield Heights, OH, USA
Kenneth W Donohue - 1Department of Orthopedic Surgery, Drexel University College of Medicine
Douglas L Cerynik - 1Department of Orthopedic Surgery, Drexel University College of Medicine
Publication Details: Acta orthopaedica, v 85(3), pp 299-304
Publisher: Nordic Orthopaedic Federation
Resource Type: Journal article
Language: English
Academic Unit: Urban Health Collaborative; Epidemiology and Biostatistics
Web of Science ID: WOS:000337845000016
Scopus ID: 2-s2.0-84902652380
Other Identifier: 991014877769604721

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Collaboration types: Domestic collaboration
Web of Science research areas: Orthopedics