Department of Orthopedic and Traumatology, San Carlo Borromeo Hospital, Milan, Italy.
University of Milan, Milan, Italy.
Eur J Orthop Surg Traumatol. 2024 Jan;34(1):523-528. doi: 10.1007/s00590-023-03697-6. Epub 2023 Aug 29.
Aim of our study was to evaluate the influence of working length and screw density on callus formation in distal tibial fractures fixed with a medial bridge plate.
42 distal tibia fractures treated with a bridge plate were analyzed. Minimum follow-up was 12 months. mRUST score (modified Radiographic Union Scale for Tibial fractures) was used to assess callus formation. Working length and screw density were measured from post-operative radiographs.
39 (92.9%) fractures healed uneventfully. 32 (76.19%) patients showed signs of early callus formation 3 months post-surgery. In these patients a lower screw density was used compared to patients who didn't show early callus (33.4 vs. 26.6; p = 0.04). No differences was noticed in working length.
Bridge plate osteosynthesis is a good treatment option in distal tibia fractures. In our series increasing the working length was not associated with a faster callus formation in distal tibia fractures. Conversely, a lower screw density proximally to the fracture site was associated to a faster callus growth.
本研究旨在评估工作长度和螺钉密度对桥接钢板固定的胫骨远端骨折骨痂形成的影响。
分析了 42 例采用桥接钢板治疗的胫骨远端骨折。最少随访 12 个月。采用改良放射学胫骨骨折愈合评分（mRUST）评估骨痂形成情况。从术后 X 线片上测量工作长度和螺钉密度。
39 例（92.9%）骨折愈合顺利。32 例（76.19%）患者术后 3 个月出现早期骨痂形成迹象。与未出现早期骨痂的患者相比，这些患者使用的螺钉密度较低（33.4 比 26.6；p=0.04）。工作长度无差异。
桥接钢板内固定是治疗胫骨远端骨折的一种较好选择。在我们的研究中，增加工作长度与胫骨远端骨折更快的骨痂形成无关。相反，骨折部位近端较低的螺钉密度与更快的骨痂生长有关。
