3.5 LCP Distal Tibia T-Plate

Michael Wagner, Micheal Schutz, Dean Lorich, Brent Norris, Sean Nork, Phil Kregor

Fig 1: Short T-plates for anterior and posterior placement

The 3.5 mm LCP distal tibia T-plate is indicated for fixation of fractures, osteotomies and non-unions of the distal tibia and is particularly useful in osteopenic bone. The system consists of short T-plates for anterior and posterior lateral placement (Fig 1) and long posterior T-plates for posterior lateral placement only. In situations that present soft-tissue concerns such as traumatic wounds or muscle flaps, the T-plate provides a good solution in the fixation of short articular and small distal meta-diaphyseal segments. The T-plate also provides an option when concomitant posterior bone grafting is necessary. 

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

The posterior T-plates (pictured right) 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 contoured to fit the posterior distal tibia. The plate edges have been rounded for a smoother insertion and provides less prominence. The plate has two locking strut screw holes to prevent collapse, four distal rafting locking screw holes and one proximal and one distal elongated hole to aid 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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