ArticleInternational journal of surgery case reports2026
Minimally invasive posterior plate osteosynthesis of a periprosthetic distal tibia shaft fracture: case report and review of literature.
Article in International journal of surgery case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction and importance: Periprosthetic fractures of the femur and tibia after total knee arthroplasty (TKA) can be difficult to treat due to pre-existing conditions and implant-related factors. The reported rate of periprosthetic fractures of tibia and femur after TKA is between 0.3 to 2.5%, in which the tibia is less frequently affected. Case presentation: This case report presents a patient with a distal tibia periprosthetic fracture in the presence of a long-stemmed revision TKA. Surrounding soft tissues were critical due to multiple previous surgeries with existing hardware due to a previous ankle fracture. In this case, the fracture was fixed internally by minimal-invasive dorsal plate osteosynthesis using a posteromedial approach proximally in combination with a posterolateral approach distally. After 6 month the fracture healed without any complications. Clinical discussion: Established methods of fracture fixation for subprosthetic fractures of the distal tibia may be unsuitable in patients with critical soft-tissue conditions. Treatment alternatives like conservative management or frame fixation may be inappropriate and associated with patient discomfort. Posterior minimally invasive plate fixation is a treatment alternative in conditions, where established techniques reach their limits. Conclusion: Minimal invasive dorsal plate osteosynthesis of a distal tibia fracture in the presence of a TKA with long stems is an option to achieve stable bone fracture healing, especially when anterior soft tissues are critical. A combination of two minimally invasive approaches to the tibia enables a safe implant insertion with a low risk of complications.
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