04/07/2010
AO Technical Commission Approved

3.5 LCP Distal Tibia T-Plate

The 3.5 mm LCP distal tibia T-plate is indicated for fixation of fractures, osteotomies, and nonunions of the distal tibia, especially in osteopenic bone. The system consists of short T-plates for anterior and posterior lateral placement and long posterior T-plates for posterior lateral placement only. It is advantageous for the fixation of short distal tibial articular/small distal metadiaphyseal segments where other approaches may be compromised due to soft-tissue concerns (traumatic wounds, muscle flap coverage, or tenuous skin). It is also an option when concomitant posterior bone grafting is required.

The T-plates come in a 3-hole (64 mm) and 5-hole (90 mm) version. They are intended for anterior and posterior placement. The plates are anatomically shaped to match the anterior and posterior distal tibia. The plate is 1.5 mm thick. It features four distal, rafting locking screws with a 5 proximal screw angle, one locking strut screw, and one elongated hole in the shaft which assists with placement.

The posterior T-plates are available in 8-hole (132 mm), 12-hole (184 mm), and 16-hole (236 mm) lengths and should only be placed on the posterior aspect of the distal tibia. The plates are anatomically shaped to match the posterior distal tibia. The plate edges have been rounded for a smoother, less prominent implant. The plate has two locking strut screws to prevent collapse, four distal, rafting locking screws, and one proximal and one distal elongated hole to aid in positioning. The design provides angular stability similar to a blade plate while maintaining ease of insertion.

The plates are part of the small fragment LCP system, and are available in stainless steel.

Case provided by Phil Kregor, Nashville, USA.
31-year-old male with a 2.5-year history of a distal tibial nonunion/malunion with three previous surgeries. Significantly compromised soft-tissue envelope anteriorly.

Removal of the intramedullary nail followed by posterior iliac bone grafting and plate fixation of both the fibula and tibia. A posterolateral approach was used to approach both the tibia and the fibula. The posterior locking T-plate was used for fixation of the tibia.

Some residual varus deformity of the tibia remains, but clinically the patient is full weight bearing and has returned to work after 4.5 months.

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