title: Distal tibial fracture: An ideal indication for external fixation using locking plate.
abstract: OBJECTIVE
  To evaluate the feasibility and efficiency of one-stage external fixation by using locking plate in distal tibial fractures.
  
  
  METHODS
  In this non-control prospective study, 28 patients with distal tibial fractures were included and underwent one-stage external fixation by using locking plate. There were 21 males and 7 females, with a mean age of 43 years (19-63). According to AO/OTA fracture classification, there were 9 cases of Type A1, 9 of Type A2, 10 of Type A3 fractures. There were 21 close and 7 open fractures. The locking plate was placed on the anteromedial aspect of the tibia with 4-5 bicortical screws inserted in both distal met- aphysis and diaphysis. The radiographic and clinic results were evaluated.
  
  
  RESULTS
  All patients were followed up for the average of 16 months (ranging from 12 to 21 months). The average surgery duration was 38 (25-60) minutes. The mean time to fracture healing were 14.6 ± 2.67, 17.5 ± 3.66, and 18.4 ± 3.37 (p < 0.05) weeks in type A1, A2, and A3 fractures respectively. By the end of the follow-ups, the mean AOFAS score were 96.11 ± 2.32, 92.67 ± 1.80 and 92.00 ± 2.06 (p > 0.05) in type A1, A2, and A3 fractures respectively. None of nonunion, deep infection, or breakage of screw or plate were observed.
  
  
  CONCLUSIONS
  Distal tibial fracture was the ideal indication for external fixation using locking plate. The external plating is characterized by ease of performance, less invasive, fewer soft tissue impingement, improved cosmesis, and convenient for removal.
authors.affiliation: Orthopaedic Surgery, Ningbo 6th Hospital, 1059 East Zhongshan Road, Ningbo 315040, Zhejiang Province, China.
authors.forename: Jing-Wei
authors.initials: JW
authors.lastname: Zhang
authors.forename: Nabil A
authors.initials: NA
authors.lastname: Ebraheim
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.forename: Xian-Feng
authors.initials: XF
authors.lastname: He
authors.forename: Joshua
authors.initials: J
authors.lastname: Schwind
authors.forename: Li-Mei
authors.initials: LM
authors.lastname: Zhu
authors.forename: Yi-Hui
authors.initials: YH
authors.lastname: Yu
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001860:Bone Plates; D015331:Cohort Studies; D016267:External Fixators / Q000706:statistics & numerical data*; D005260:Female; D017102:Fracture Healing / Q000502:physiology*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult