Dr. Codrin Huszar on the Benefits of LCP Distal Tibial Medial Plates
An interview with Dr. Codrin Huszar, senior orthopedic surgeon, about the LCP-Distal Tibial Medial Plate implant used in distal tibial fractures and in corrective osteotomies of the ankle axis.
Fractures are a painful experience, and once we realize that our mobility may be affected, the worry sets in. Even if the prospect of surgery for these injuries feels frightening, experience shows that patients can achieve a complete restoration of locomotor function.
Regardless of the pain or the severity of the fracture, see a doctor. The odds are good that you will recover fully in a short time, but that requires teaming up with the person in whose hands you have placed your health and your return to normal life.
We spoke about the advantages of using the "LCP-Distal Tibial Medial Plate" implant in surgery (a titanium plate used in distal tibial fractures, featuring special holes that accept both screws that lock into the plate and classic compression screws, whether cancellous or cortical) with Dr. Codrin Huszar, senior orthopedic surgeon, in the Department of Orthopedics and Sports Traumatology at Sanador Hospital in Bucharest. These plates, known as LCP (Locking Compression Plate), have the advantage that a single plate can achieve both locking and compression at the fracture site of the bone.
Why did you choose the "LCP-Distal Tibial Medial Plate" implant?
Dr. Codrin Huszar: I use the "LCP-Distal Tibial Medial Plate" implant in surgery because of its precise, intuitive instrumentation and very useful accessories. The screws grip excellently regardless of type, whether I use cortical, cancellous, or locking screws. Another benefit of this implant is that it can be inserted using a minimally invasive technique.
One particular category of pathology in which I use this implant is distal tibial osteotomies for correcting the axis of the ankle.
When I use the pre-shaped plate for corrective ankle-axis osteotomies, I rely on the shape of the plate to align the tibia to the plate — an additional criterion for verifying the correction, beyond the preoperative radiological calculation.
To illustrate some of the points mentioned above, let me present two cases:
V. (male patient) is a 58-year-old man who underwent a distal valgus osteotomy of the tibia and reconstruction of the lateral collateral ligament of the ankle due to chronic ankle instability with varus-malaligned osteoarthritis.
A. (male patient) is a 42-year-old man who required surgery for internal fixation of a fracture of the distal third of the tibia, with a "butterfly" fragment and a fracture line extending into and involving the tibial articular surface.
What advantages does this implant offer?
Dr. Codrin Huszar: Although it is more difficult to use than a classic plate, where the fracture site is opened, and the surgery takes longer, the "LCP-Distal Tibial Medial Plate" implant offers several advantages.
The robust fixation achieved with distal tibial medial plates prevents construct failure or secondary displacement of the fragments, and thus allows rehabilitation procedures to begin early — a very important stage in the process of returning patients to their pre-fracture life.
There are two other features of this implant that make me consider it easy to use: the reliability and quality of the plate-screw construct also allow for easy removal of the screws once the fracture or osteotomy has healed. Consequently, the "LCP-Distal Tibial Medial Plate" implant carries a minimal risk of screws seizing in the plate or of thread damage during hardware removal.
How soon can postoperative recovery begin, and how long does it take for the patient to return to their pre-accident condition?
Dr. Codrin Huszar: Many patients could hardly believe it when I told them that after surgery they would feel no discomfort. The distal tibial medial plate has a low profile and conforms very well to the bone, which is precisely why it does not bother patients after implantation, even though it is positioned on the subcutaneous surface of the tibia.
In the case of a tibial fracture, the immobilization period is short, between 1 and 2 months. At the same time, a medical rehabilitation plan is required to strengthen the muscles around the foot and ankle. This is followed by balance-improvement exercises with progressive weight-bearing. The entire rehabilitation program can take as long as 3 months, and patients will most certainly recover and be able to resume their pre-accident life after 6 months, though there are cases where recovery takes even longer.