Tension Band Plating for Chronic Anterior Tibial Stress Fractures in High-Performance Athletes.

Détails

ID Serval
serval:BIB_BECB9639CE3C
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Tension Band Plating for Chronic Anterior Tibial Stress Fractures in High-Performance Athletes.
Périodique
American Journal of Sports Medicine
Auteur(s)
Zbeda R.M., Sculco P.K., Urch E.Y., Lazaro L.E., Borens O., Williams R.J., Lorich D.G., Wellman D.S., Helfet D.L.
ISSN
1552-3365 (Electronic)
ISSN-L
0363-5465
Statut éditorial
Publié
Date de publication
2015
Volume
43
Numéro
7
Pages
1712-1718
Langue
anglais
Notes
Publication types: Journal Article Publication Status: ppublish
Résumé
BACKGROUND: Anterior tibial stress fractures are associated with high rates of delayed union and nonunion, which can be particularly devastating to a professional athlete who requires rapid return to competition. Current surgical treatment strategies include intramedullary nailing, which has satisfactory rates of fracture union but an associated risk of anterior knee pain. Anterior tension band plating is a biomechanically sound alternative treatment for these fractures.
HYPOTHESIS: Tension band plating of chronic anterior tibial stress fractures leads to rapid healing and return to physical activity and avoids the anterior knee pain associated with intramedullary nailing.
STUDY DESIGN: Case series; Level of evidence, 4.
METHODS: Between 2001 and 2013, there were 13 chronic anterior tibial stress fractures in 12 professional or collegiate athletes who underwent tension band plating after failing nonoperative management. Patient charts were retrospectively reviewed for demographics, injury history, and surgical details. Radiographs were used to assess time to osseous union. Follow-up notes and phone interviews were used to determine follow-up time, return to training time, and whether the patient was able to return to competition.
RESULTS: Cases included 13 stress fractures in 12 patients (9 females, 3 males). Five patients were track-and-field athletes, 4 patients played basketball, 2 patients played volleyball, and 1 was a ballet dancer. Five patients were Division I collegiate athletes and 7 were professional or Olympic athletes. Average age at time of surgery was 23.6 years (range, 20-32 years). Osseous union occurred on average at 9.6 weeks (range, 5.3-16.9 weeks) after surgery. Patients returned to training on average at 11.1 weeks (range, 5.7-20 weeks). Ninety-two percent (12/13) eventually returned to preinjury competition levels. Thirty-eight percent (5/13) underwent removal of hardware for plate prominence. There was no incidence of infection or nonunion.
CONCLUSION: Anterior tension band plating for chronic tibial stress fractures provides a reliable alternative to intramedullary nailing with excellent results. Compression plating avoids the anterior knee pain associated with intramedullary nailing but may result in symptomatic hardware requiring subsequent removal.
Pubmed
Web of science
Création de la notice
07/01/2016 16:23
Dernière modification de la notice
20/08/2019 16:33
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