Bridge Plating for Simple Tibial Fractures Treated by Minimally Invasive Plate Osteosynthesis

Introduction: Simple fractures, potentially high-strain fractures, are classically treated through anatomical reconstruction and rigid fixation, using an open reduction approach. This study aimed to evaluate the bridge plating through the minimally invasive plate osteosynthesis (MIPO) of simple tibial fractures. Our hypothesis was that the bridge fixation of these fractures using MIPO would result in early bone healing with low complication rates.

Materials and Methods: Clinical and radiographic records of twenty-nine dogs with simple tibial fractures that have undergone bridge fixation using MIPO were retrospectively assessed. The tibial mechanical joint angles were measured and compared with the values described in the literature (p <0.05). Additionally, fragment apposition and implant disposition were evaluated. Based on the modified Radiographic Union Scale for Tibial fractures, the moment of clinical union was determined.

Results: The tibial plateau angle was significantly lower (p = 0.001) than value described in the literature. The median fragment apposition was considered acceptable. The average bridge plate ratio, plate working length, and plate screw density were 0.8, 0.57, and 0.48, respectively. The median time to clinical union was 30 days.

Discussion/Conclusion: Considering our Results, bridge plating of simple tibial fractures by MIPO in dogs was satisfactory, supporting the initial hypothesis. In general, it is justified by the balance achieved between the mechanical and biological environments, which allowed for the formation of fibrous/cartilaginous callus fast enough to increase construction stiffness and neutralise the expected excess movement. In Conclusion, bridge fixation can be applied in simple tibial fractures. Biological osteosynthesis might have contributed to our thriving Results.

Acknowledgement: This study was funded by the Sao Paulo State Foundation – FAPESP (2012/20642–4 and 2012/16712–7) and CAPES.

Publication History

Article published online:
26 October 2022