title: [Minimally invasive plate osteosynthesis of the distal tibia].
abstract: OBJECTIVE
  Minimally invasive plate osteosynthesis of distal metaphyseal and/or diaphyseal tibial fractures.
  
  
  METHODS
  Extraarticular tibial fractures or distal tibial fractures with simple intraarticular components (AO 42 A-C + AO 43 A, C1, C2) of the distal tibia shaft. Closed or open soft tissue conditions, most suitable for closed soft tissue damage Oestern-Tscherne grade I-II.
  
  
  METHODS
  High degree open fractures, where the plate would not be covered by soft tissue. Comminuted Pilon fractures.
  
  
  METHODS
  Closed reduction manually, over the plate or the external fixator/large distractor. Short incision on the medial malleolus. Epiperosteal insertion of the plate anteromedial. Improve reduction stepwise and insertion of screws on each main fragment. Relative stability is achieved by using bridging techniques. Fibula fixation in special cases.
  
  
  METHODS
  Mobilization after 1-3 days with toe-touch weight bearing. Full weight bearing after 8-10 weeks. Implant removal optional after 1-2 years in cases of soft tissue irritation.
  
  
  RESULTS
  Uneventful healing with good function was observed in 85% of patients within 4 months. Delayed unions were observed in 5-10% of cases and nonunions or malalignment were observed in 5% of patients. All patients were satisfied with function at the 2-year follow-up.
authors.affiliation: Department Chirurgie, Kantonsspital Graubünden, Loestr. 170, 7000, Chur, Schweiz. thomas.mueller@ksgr.ch
authors.forename: T S
authors.initials: TS
authors.lastname: Müller
authors.forename: C
authors.initials: C
authors.lastname: Sommer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D001860:Bone Plates; D001863:Bone Screws; D001864:Bone Wires; D002648:Child; D005260:Female; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D021621:Imaging, Three-Dimensional; D057072:Intra-Articular Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult